Increasing the angle between caudal screw and the transverse plane may aggravate the risk of femoral head necrosis by deteriorating the fixation stability in patients with femoral neck fracture
Abstract Necrosis of the femoral head is the main complication in femoral neck fracture patients with triangle cannulated screw fixation. Instant postoperative fixation instability is a main reason for the higher risk of femoral head necrosis. Biomechanical studies have shown that cross screw fixati...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40001-024-01737-3 |
| _version_ | 1797259432528183296 |
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| author | Jian Zhang Shengyu Wan Xiaozhong Luo Caidong Zhang Chao Wu Lipeng He Jingchi Li |
| author_facet | Jian Zhang Shengyu Wan Xiaozhong Luo Caidong Zhang Chao Wu Lipeng He Jingchi Li |
| author_sort | Jian Zhang |
| collection | DOAJ |
| description | Abstract Necrosis of the femoral head is the main complication in femoral neck fracture patients with triangle cannulated screw fixation. Instant postoperative fixation instability is a main reason for the higher risk of femoral head necrosis. Biomechanical studies have shown that cross screw fixation can effectively optimize fixation stability in patients with proximal humerus fractures and pedicle screw fixation, but whether this method can also effectively optimize the fixation stability of femoral neck fractures and reduce the corresponding risk of femoral head necrosis has yet to be identified. In this study, a retrospective review of imaging data in femoral neck fracture patients was performed. The cross angle between the femoral neck and the caudal cannulated screw was reported; if the angle between the screw and the transverse plane increased, it was recorded as positive; otherwise, it was recorded as negative. Angle values and their corresponding absolute values were compared in patients with and without femoral head necrosis. Regression analysis identified potential risk factors for femoral head necrosis. Moreover, the biomechanical effect of the screw–femoral neck angle on fixation stability was also verified by numerical mechanical simulations. Clinical review presented significantly larger positive angle values in patients with femoral head necrosis, which was also proven to be an independent risk factor for this complication. Moreover, fixation stability progressively deteriorated with increasing angle between the caudal screw and the transverse plane. Therefore, increasing the angle between the caudal screw and the transverse plane may aggravate the risk of femoral head necrosis by deteriorating the fixation stability in patients with femoral neck fracture. |
| first_indexed | 2024-04-24T23:09:20Z |
| format | Article |
| id | doaj.art-7cf26a80284b46299ec765cc0282f6e9 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-04-24T23:09:20Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-7cf26a80284b46299ec765cc0282f6e92024-03-17T12:19:38ZengBMCEuropean Journal of Medical Research2047-783X2024-03-0129111010.1186/s40001-024-01737-3Increasing the angle between caudal screw and the transverse plane may aggravate the risk of femoral head necrosis by deteriorating the fixation stability in patients with femoral neck fractureJian Zhang0Shengyu Wan1Xiaozhong Luo2Caidong Zhang3Chao Wu4Lipeng He5Jingchi Li6Department of Orthopaedics, Zigong Fourth People’s HospitalDepartment of Orthopaedics, Zigong Fourth People’s HospitalDepartment of Orthopaedics, Zigong Fourth People’s HospitalDepartment of Orthopaedics, Zigong Fourth People’s HospitalDepartment of Orthopaedics, Zigong Fourth People’s HospitalDepartment of Orthopaedics, Wuxi Hospital of Traditional Chinese MedicineDepartment of Orthopedics, Luzhou Key Laboratory of Orthopedic Disorders, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical UniversityAbstract Necrosis of the femoral head is the main complication in femoral neck fracture patients with triangle cannulated screw fixation. Instant postoperative fixation instability is a main reason for the higher risk of femoral head necrosis. Biomechanical studies have shown that cross screw fixation can effectively optimize fixation stability in patients with proximal humerus fractures and pedicle screw fixation, but whether this method can also effectively optimize the fixation stability of femoral neck fractures and reduce the corresponding risk of femoral head necrosis has yet to be identified. In this study, a retrospective review of imaging data in femoral neck fracture patients was performed. The cross angle between the femoral neck and the caudal cannulated screw was reported; if the angle between the screw and the transverse plane increased, it was recorded as positive; otherwise, it was recorded as negative. Angle values and their corresponding absolute values were compared in patients with and without femoral head necrosis. Regression analysis identified potential risk factors for femoral head necrosis. Moreover, the biomechanical effect of the screw–femoral neck angle on fixation stability was also verified by numerical mechanical simulations. Clinical review presented significantly larger positive angle values in patients with femoral head necrosis, which was also proven to be an independent risk factor for this complication. Moreover, fixation stability progressively deteriorated with increasing angle between the caudal screw and the transverse plane. Therefore, increasing the angle between the caudal screw and the transverse plane may aggravate the risk of femoral head necrosis by deteriorating the fixation stability in patients with femoral neck fracture.https://doi.org/10.1186/s40001-024-01737-3Femoral neck fractureFemoral head necrosisFinite element analysisScrew trajectory optimizationFixation stability |
| spellingShingle | Jian Zhang Shengyu Wan Xiaozhong Luo Caidong Zhang Chao Wu Lipeng He Jingchi Li Increasing the angle between caudal screw and the transverse plane may aggravate the risk of femoral head necrosis by deteriorating the fixation stability in patients with femoral neck fracture European Journal of Medical Research Femoral neck fracture Femoral head necrosis Finite element analysis Screw trajectory optimization Fixation stability |
| title | Increasing the angle between caudal screw and the transverse plane may aggravate the risk of femoral head necrosis by deteriorating the fixation stability in patients with femoral neck fracture |
| title_full | Increasing the angle between caudal screw and the transverse plane may aggravate the risk of femoral head necrosis by deteriorating the fixation stability in patients with femoral neck fracture |
| title_fullStr | Increasing the angle between caudal screw and the transverse plane may aggravate the risk of femoral head necrosis by deteriorating the fixation stability in patients with femoral neck fracture |
| title_full_unstemmed | Increasing the angle between caudal screw and the transverse plane may aggravate the risk of femoral head necrosis by deteriorating the fixation stability in patients with femoral neck fracture |
| title_short | Increasing the angle between caudal screw and the transverse plane may aggravate the risk of femoral head necrosis by deteriorating the fixation stability in patients with femoral neck fracture |
| title_sort | increasing the angle between caudal screw and the transverse plane may aggravate the risk of femoral head necrosis by deteriorating the fixation stability in patients with femoral neck fracture |
| topic | Femoral neck fracture Femoral head necrosis Finite element analysis Screw trajectory optimization Fixation stability |
| url | https://doi.org/10.1186/s40001-024-01737-3 |
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