Is there an increased risk for subtrochanteric stress fracture with the Femoral Neck System versus multiple cannulated screws fixation?

Megan R Hsu; Henry T Shu; Kitchai Luksameearunothai; Adam Margalit; Andrew T Yu; Erik A Hasenboehler; Babar Shafiq

doi:10.1016/j.jor.2022.02.016

Is there an increased risk for subtrochanteric stress fracture with the Femoral Neck System versus multiple cannulated screws fixation?

J Orthop. 2022 Feb 16:30:127-133. doi: 10.1016/j.jor.2022.02.016. eCollection 2022 Mar-Apr.

Authors

Megan R Hsu¹, Henry T Shu¹, Kitchai Luksameearunothai², Adam Margalit¹, Andrew T Yu³, Erik A Hasenboehler⁴, Babar Shafiq¹

Affiliations

¹ Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
² Department of Orthopaedic Surgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
³ Department of Neurology, The Johns Hopkins University, Baltimore, MD, USA.
⁴ Orthopedic Institute of Pennsylvania, Camp Hill, PA, USA.

Abstract

Purpose: This study sought to compare the risk of subtrochanteric stress-riser fractures and biomechanical stability of the Femoral Neck System (FNS) versus multiple screw fixation (MSF).

Methods: Eight paired cadaveric femurs were randomly assigned to FNS or MSF. Physiologic load mimicking single leg stance at the subtrochanteric region was applied to the constructs.

Results: No constructs failed in the subtrochanteric region during loading. There was no significant difference in force (P = 0.364) or loading cycles (P = 0.348) between groups.

Conclusion: FNS constructs were not associated with an increased incidence of iatrogenic subtrochanteric fractures or biomechanical stability versus MSF.

Keywords: Biomechanics; Cannulated screws; Femoral neck fractures; Femoral neck system; Orthopedic trauma; Stress fracture.