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Introduction <p>Nondisplaced and valgus-impacted femoral neck fractures have traditionally been treated with screw fixation, but reoperation rates remain high. This study reports clinical outcomes following internal fixation of low-energy femoral neck fractures (AO/OTA 31B1.1 and 31B1.2) using a new, fixed-angle sliding device.</p> Methods <p>This was a multi-institutional retrospective review at four academic Level I Trauma Centers, one Level II Trauma Center, and one Level III Trauma Center. Patients with AO/OTA 31B1.1 and 31B1.2 fractures who underwent internal fixation using the Femoral Neck System (“FNS,” DePuy Synthes, West Chester, PA) and had follow-up to radiographic union or reoperation (mean 11.9&#xa0;months) were included. Fractures with ≥ 20° of posterior tilt were included but distinguished as the “posterolateral” group. Primary outcome was reoperation rate. Secondary outcomes included fixation failure, infection, nonunion, and mortality rates at 3 and 6&#xa0;months.</p> Results <p>A total of 116 patients met inclusion criteria including 109 “stable” fractures with &lt; 20° of posterior tilt, and seven valgus-impacted fractures with ≥ 20° of posterior tilt (“posterolateral”). All posterolateral fractures underwent a reduction maneuver to reduce posterior tilt prior to fixation. Overall reoperation rate was 10%, including a 5.2% reoperation rate for AVN, with no patients in the posterolateral group requiring reoperation. Nonunion rate was 1.8%, and there was only one case of acute fixation failure (0.9%), which occurred after a repeat fall. Mortality rate was 0.9% at 3&#xa0;months and 2.2% at 6&#xa0;months.</p> Conclusions <p>Surgical fixation of nondisplaced and valgus-impacted femoral neck fractures with a femoral neck-specific, fixed-anglescrew-side plate device appears safe and effective. Reoperation rate remained low in the high-risk posterolateral subgroup when reduction maneuvers were performed.</p> Level of evidence <p>III.</p>

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Early outcomes of the synthes femoral neck system for valgus-impacted femoral neck fractures: a multicenter retrospective study

  • 期刊论文

  • 发表日期：

    2025年8月26日

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  • Noelle L. Van Rysselberghe ,
  • Harsh Wadhwa,
  • Seth S. Tigchelaar,
  • Sara K. Shin,
  • Rosser W. McCallie,
  • Evan M. Miller,
  • Ameen Barghi,
  • Richard S. Moore,
  • Andrea Hankins,
  • Jennifer Sharp,
  • Robert P. Dunbar,
  • Michael F. Githens,
  • Sean E. Nork,
  • Conor P. Kleweno,
  • Michael J. Bellino,
  • Christopher Parks,
  • Jonah Hebert-Davies,
  • Eben A. Carroll,
  • Christopher G. Finkemeier,
  • L. Henry Goodnough,
  • Julius A. Bishop,
  • Michael J. Gardner

摘要

Introduction

Nondisplaced and valgus-impacted femoral neck fractures have traditionally been treated with screw fixation, but reoperation rates remain high. This study reports clinical outcomes following internal fixation of low-energy femoral neck fractures (AO/OTA 31B1.1 and 31B1.2) using a new, fixed-angle sliding device.

Methods

This was a multi-institutional retrospective review at four academic Level I Trauma Centers, one Level II Trauma Center, and one Level III Trauma Center. Patients with AO/OTA 31B1.1 and 31B1.2 fractures who underwent internal fixation using the Femoral Neck System (“FNS,” DePuy Synthes, West Chester, PA) and had follow-up to radiographic union or reoperation (mean 11.9 months) were included. Fractures with ≥ 20° of posterior tilt were included but distinguished as the “posterolateral” group. Primary outcome was reoperation rate. Secondary outcomes included fixation failure, infection, nonunion, and mortality rates at 3 and 6 months.

Results

A total of 116 patients met inclusion criteria including 109 “stable” fractures with < 20° of posterior tilt, and seven valgus-impacted fractures with ≥ 20° of posterior tilt (“posterolateral”). All posterolateral fractures underwent a reduction maneuver to reduce posterior tilt prior to fixation. Overall reoperation rate was 10%, including a 5.2% reoperation rate for AVN, with no patients in the posterolateral group requiring reoperation. Nonunion rate was 1.8%, and there was only one case of acute fixation failure (0.9%), which occurred after a repeat fall. Mortality rate was 0.9% at 3 months and 2.2% at 6 months.

Conclusions

Surgical fixation of nondisplaced and valgus-impacted femoral neck fractures with a femoral neck-specific, fixed-anglescrew-side plate device appears safe and effective. Reoperation rate remained low in the high-risk posterolateral subgroup when reduction maneuvers were performed.

Level of evidence

III.