Comparing Perioperative Outcome Measures of the Dynamic Hip Screw and the Femoral Neck System
<i>Background and Objective</i>: Various fixation devices and surgical techniques are available for the management of proximal femur fractures. Recently, the femoral neck system (FNS) was introduced, and was promoted on the basis of less invasiveness, shorter operating time, and less flu...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2022-02-01
|
Series: | Medicina |
Subjects: | |
Online Access: | https://www.mdpi.com/1648-9144/58/3/352 |
_version_ | 1797445347906158592 |
---|---|
author | Marcel Niemann Karl F. Braun Sufian S. Ahmad Ulrich Stöckle Sven Märdian Frank Graef |
author_facet | Marcel Niemann Karl F. Braun Sufian S. Ahmad Ulrich Stöckle Sven Märdian Frank Graef |
author_sort | Marcel Niemann |
collection | DOAJ |
description | <i>Background and Objective</i>: Various fixation devices and surgical techniques are available for the management of proximal femur fractures. Recently, the femoral neck system (FNS) was introduced, and was promoted on the basis of less invasiveness, shorter operating time, and less fluoroscopy time compared to previous systems. The aim of this study was to compare two systems for the internal fixation of femoral neck fractures (FNF), namely the dynamic hip screw (DHS) with an anti-rotation screw (ARS) and an FNS. The outcome measures included operating room time (ORT), dose–area product (DAP), length of stay (LOS), perioperative changes in haemoglobin concentrations, and transfusion rate. <i>Materials and Methods</i>: A retrospective single-centre study was conducted. Patients treated for FNF between 1 January 2020 and 30 September 2021 were included, provided that they had undergone closed reduction and internal fixation. We measured the centrum-collum-diaphyseal (CCD) and the Pauwels angle preoperatively and one week postoperatively. <i>Results</i>: In total, 31 patients (16 females), with a mean age of 62.81 ± 15.05 years, were included. Fracture complexity assessed by the Pauwels and Garden classification did not differ between groups preoperatively. Nonetheless, the ORT (54 ± 26.1 min vs. 91.68 ± 23.96 min, <i>p</i> < 0.01) and DAP (721 ± 270.6 cGycm² vs. 1604 ± 1178 cGycm², <i>p</i> = 0.03) were significantly lower in the FNS group. The pre- and postoperative CCD and Pauwels angles did not differ statistically between groups. Perioperative haemoglobin concentration changes (–1.77 ± 1.19 g/dl vs. –1.74 ± 1.37 g/dl) and LOS (8 ± 5.27 days vs. 7.35 ± 3.43 days) were not statistically different. <i>Conclusions</i>: In this cohort, the ORT and DAP were almost halved in the patient group treated with FNS. This may confer a reduction in secondary risks related to surgery. |
first_indexed | 2024-03-09T13:24:29Z |
format | Article |
id | doaj.art-91ed2ff613ae485cb3b94fe9b97821a6 |
institution | Directory Open Access Journal |
issn | 1010-660X 1648-9144 |
language | English |
last_indexed | 2024-03-09T13:24:29Z |
publishDate | 2022-02-01 |
publisher | MDPI AG |
record_format | Article |
series | Medicina |
spelling | doaj.art-91ed2ff613ae485cb3b94fe9b97821a62023-11-30T21:25:43ZengMDPI AGMedicina1010-660X1648-91442022-02-0158335210.3390/medicina58030352Comparing Perioperative Outcome Measures of the Dynamic Hip Screw and the Femoral Neck SystemMarcel Niemann0Karl F. Braun1Sufian S. Ahmad2Ulrich Stöckle3Sven Märdian4Frank Graef5Center for Musculoskeletal Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, 13353 Berlin, GermanyCenter for Musculoskeletal Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, 13353 Berlin, GermanyCenter for Musculoskeletal Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, 13353 Berlin, GermanyCenter for Musculoskeletal Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, 13353 Berlin, GermanyCenter for Musculoskeletal Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, 13353 Berlin, GermanyCenter for Musculoskeletal Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, 13353 Berlin, Germany<i>Background and Objective</i>: Various fixation devices and surgical techniques are available for the management of proximal femur fractures. Recently, the femoral neck system (FNS) was introduced, and was promoted on the basis of less invasiveness, shorter operating time, and less fluoroscopy time compared to previous systems. The aim of this study was to compare two systems for the internal fixation of femoral neck fractures (FNF), namely the dynamic hip screw (DHS) with an anti-rotation screw (ARS) and an FNS. The outcome measures included operating room time (ORT), dose–area product (DAP), length of stay (LOS), perioperative changes in haemoglobin concentrations, and transfusion rate. <i>Materials and Methods</i>: A retrospective single-centre study was conducted. Patients treated for FNF between 1 January 2020 and 30 September 2021 were included, provided that they had undergone closed reduction and internal fixation. We measured the centrum-collum-diaphyseal (CCD) and the Pauwels angle preoperatively and one week postoperatively. <i>Results</i>: In total, 31 patients (16 females), with a mean age of 62.81 ± 15.05 years, were included. Fracture complexity assessed by the Pauwels and Garden classification did not differ between groups preoperatively. Nonetheless, the ORT (54 ± 26.1 min vs. 91.68 ± 23.96 min, <i>p</i> < 0.01) and DAP (721 ± 270.6 cGycm² vs. 1604 ± 1178 cGycm², <i>p</i> = 0.03) were significantly lower in the FNS group. The pre- and postoperative CCD and Pauwels angles did not differ statistically between groups. Perioperative haemoglobin concentration changes (–1.77 ± 1.19 g/dl vs. –1.74 ± 1.37 g/dl) and LOS (8 ± 5.27 days vs. 7.35 ± 3.43 days) were not statistically different. <i>Conclusions</i>: In this cohort, the ORT and DAP were almost halved in the patient group treated with FNS. This may confer a reduction in secondary risks related to surgery.https://www.mdpi.com/1648-9144/58/3/352dynamic hip screwfemoral neck systemfemoral neck fractureindividual medicineminimal-invasive surgerymultiple trauma |
spellingShingle | Marcel Niemann Karl F. Braun Sufian S. Ahmad Ulrich Stöckle Sven Märdian Frank Graef Comparing Perioperative Outcome Measures of the Dynamic Hip Screw and the Femoral Neck System Medicina dynamic hip screw femoral neck system femoral neck fracture individual medicine minimal-invasive surgery multiple trauma |
title | Comparing Perioperative Outcome Measures of the Dynamic Hip Screw and the Femoral Neck System |
title_full | Comparing Perioperative Outcome Measures of the Dynamic Hip Screw and the Femoral Neck System |
title_fullStr | Comparing Perioperative Outcome Measures of the Dynamic Hip Screw and the Femoral Neck System |
title_full_unstemmed | Comparing Perioperative Outcome Measures of the Dynamic Hip Screw and the Femoral Neck System |
title_short | Comparing Perioperative Outcome Measures of the Dynamic Hip Screw and the Femoral Neck System |
title_sort | comparing perioperative outcome measures of the dynamic hip screw and the femoral neck system |
topic | dynamic hip screw femoral neck system femoral neck fracture individual medicine minimal-invasive surgery multiple trauma |
url | https://www.mdpi.com/1648-9144/58/3/352 |
work_keys_str_mv | AT marcelniemann comparingperioperativeoutcomemeasuresofthedynamichipscrewandthefemoralnecksystem AT karlfbraun comparingperioperativeoutcomemeasuresofthedynamichipscrewandthefemoralnecksystem AT sufiansahmad comparingperioperativeoutcomemeasuresofthedynamichipscrewandthefemoralnecksystem AT ulrichstockle comparingperioperativeoutcomemeasuresofthedynamichipscrewandthefemoralnecksystem AT svenmardian comparingperioperativeoutcomemeasuresofthedynamichipscrewandthefemoralnecksystem AT frankgraef comparingperioperativeoutcomemeasuresofthedynamichipscrewandthefemoralnecksystem |