IOA 2022

The New Femoral Neck System: A Single-institution Experience of the First 40 Cases

Ahmad Essa 1,2 Erick Kachko 1 Uri Hazan 1 Hadas Daniel 1 Yiftach Beer 1,2 Ram Efrati 1,2
1Department of Orthopaedics, Shamir Medical Center (Assaf Harofeh), Israel
2Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Objective:
To evaluate the efficacy of the new femoral neck system (FNS) in treating intracapsular femoral neck fractures (IFNF) by assessing postoperative outcomes and later sequela, including fracture union, screw cut-out, femoral head avascular necrosis and the rate of cases redeemed to arthroplasty revision surgery.

Methods and Material:
A retrospective study of all patients treated by the new femoral neck system (FNS) between 2019 and 2020 at medium-sized medical center following IFNF. Post-operative and hospitalization medical records of each patient were examined for later sequelae. Follow up clinic intervals were: 2 weeks, 1 month, 3 months, 6 months and 1 year after hospital discharge. Descriptive statistics were used to describe and review the accumulated data.

Results:
The study included 40 patients treated by the new FNS fixator between the years 2019-2020 with minimum post-operative follow up time of 6 months. Mean age was 62.33 (SD ±14.01), with almost 1:1 male to female ratio (51% vs 49%). Twenty seven out of 40 patients (68%) were classified with stable intracapsular femoral neck fractures (Garden 1- 2). The median time to surgery was 7 hours (range, 0.33-33 hours) from admission. Six out of 40 patients had later sequelae requiring arthroplasty revision surgery (15%), in which included: 2 cut-out, 2 AVN and 2 non-union. Median time till revision was 7 weeks (Range, 2.8-32 weeks).

The median age in the revision group (RG) was significantly higher compared to the rest of patients (72.17 ± 9.64 vs 60.55 ± 14.04, p=0.032), as was the surgery duration in minutes (48 vs 34, p=0.015). In addition, surgeon’s experience of less than 5 years was significantly associated with future revision surgery (p=0.036).

Conclusion:
The FNS seems to be effective in treating IFNF, specifically if performed by an experienced surgeon in relatively young patients. However, a revision rate of 15% should be considered.