CONTRIBUTING FACTORS TO EARLY FAILURE OF THE FEMORAL NECK SYSTEM (FNS) IN FEMORAL NECK FRACTURE PATIENTS
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Keywords
Femoral Neck Fracture, Femoral Neck System, Internal Fixation, Bone Healing, Implant Stability
Abstract
Background: The Femoral Neck System (FNS) is an innovative internal fixation device widely utilized for managing femoral neck fractures (FNFs). Compared to traditional fixation techniques, FNS offers a minimally invasive approach, providing enhanced stability and promising short-term outcomes. However, early failure of FNS (EFFNS) remains a concern, with limited research available on the factors contributing to this issue. This study aims to investigate the prevalence and potential risk factors associated with EFFNS.
Methods: This study is a retrospective analysis that has been conducted on 110 patients with FNF undergoing FNS fixation in Rashid Hospital Dubai from December 2022 to December 2024. Data on demographics, clinical characteristics, radiographic parameters, and treatment details were collected. Multifactor logistic regression analysis was performed to evaluate the contributing factors to EFFNS.
Results: Out of 110 patients, 18 (16.4%) developed EFFNS. This included 11 cases of severe femoral neck shortening, 4 instances of screw migration, 2 occurrences of avascular necrosis of the head of femur, and one case of nonunion. All individuals in the failure group were younger than 65 years, a proportion significantly higher than the 61.2% observed in the healing group (P = 0.010). No significant differences were found in sex (P = 0.478), BMI (P = 0.695), affected side (P = 0.328), injury cause (P = 0.604), reduction approach (P = 0.562), femoral neck-shaft angle (P = 0.531), Pauwels classification (P = 0.549), or Garden classification (P = 0.208). Additionally, multivariate analysis did not establish Garden classification (P = 0.457) or age (P = 0.122) as notable risk factors for EFFNS.
Conclusion: This study determined that factors such as sex, BMI, injury mechanism, injury side, reduction method, femoral neck-shaft angle, Pauwels angle, Pauwels classification, and Garden classification were not significantly associated with EFFNS. Moreover, multivariate analysis did not identify age or Garden classification as independent risk factors for early FNS failure. These insights may contribute to optimizing treatment approaches and enhancing clinical outcomes in femoral neck fracture management.
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Dr. Waleed Kamaleldin
Orthopedic and Trauma Surgeon, Trauma Center, Rashid Hospital Dubai, UAE.
Dr. Mohamed Ghoneem
Orthopedic and Trauma Surgeon, Trauma Center, Rashid Hospital Dubai, UAE.
Dr. Zeeshan Khan
Orthopedic and Trauma Surgeon, Trauma Center, Rashid Hospital Dubai, UAE.