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Multicenter Study
. 2024 Oct;50(5):2219-2227.
doi: 10.1007/s00068-024-02552-5. Epub 2024 May 31.

The dynamic locking blade plate: seven-year follow-up results of 389 patients with a femoral neck fracture

J H Kalsbeek  1   2 , W H Roerdink  3 , P Krijnen  4   5 , C A S Berende  6 , J T Winkelhorst  7 , A D P van Walsum  8 , I B Schipper  4
Affiliations
Multicenter Study

The dynamic locking blade plate: seven-year follow-up results of 389 patients with a femoral neck fracture

J H Kalsbeek et al. Eur J Trauma Emerg Surg. 2024 Oct.

Abstract

Purpose: This study aimed to investigate the long-term outcomes of patients with a femoral neck fracture (FNF), treated with the Dynamic Locking Blade Plate (DLBP).

Methods: Retrospective analysis of prospectively collected data of a multicentre cohort of patients with FNFs was conducted, regarding the long-term incidence of revision surgery after DLBP. Implant failure was evaluated using Kaplan-Meier and Cox regression analysis. Secondary outcomes were the indication for revision surgery, complications, time to revision surgery, rate of elective removal of the implant, potential predictors for revision surgery and mortality.

Results: Median follow-up of 389 included patients was 98 months; 20.6% underwent revision surgery; 28.8% after treatment of a displaced FNF (dFNF) and 10.0% with a undisplaced FNF (uFNF). 5.7% (n = 22) of the patients had operation related complications and 32.9% (n = 128) deceased during follow-up. Median time to revision surgery was 13 (dFNF) and 18 months (uFNF). 15.7% of the DLBPs were electively removed. In the multivariate Cox regression analysis, female gender (hazard ratio 2.1, 95% CI 1.2-3.7) and a TAD > 25 mm (hazard ratio 2.9, 95% CI 1.7-5) were significant predictors for revision surgery in patients with dFNF.

Conclusion: This study is the first long-term follow-up study on the outcome of the DLBP. The DLBP demonstrated positive long-term results in the treatment of FNF.

Keywords: Displaced undisplaced; Dynamic locking blade plate; Femoral neck fracture; Hip fracture; Internal fixation; Intracapsular hip fracture.

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Conflict of interest statement

Declarations. Ethics approval: Statement of the Medical research Ethics Committees United: referring to your study (reference number W21.268) it is hereby confirmed that the Medical Research Involving Human Subjects (WMO) does not apply to this study and that therefore an official approval of this study by the MEC-U is not required under the WMO. Statement is included in attached files. Consent to participate: The measurements and analysis corresponded with those in earlier studies for which the participants consented to participate. If the primary parameter could not be retrieved from the patient records the patients were called and asked if they would participate in a small survey (included in the attached files). From this survey the primary outcome parameter and some of the secondary parameters can be retrieved. Patients were free to answer the questions of the survey. Consent for publication: not applicable. Conflicts of interest: A.D.P. van Walsum owned part of the DLBP patent and owned shares in the Gannet (DLBP) company. J.H. Kalsbeek, W.H. Roerdink, P. Krijnen, C.A.S. Berende, J.T. Winkelhorst and I.B. Schipper have no conflicts of interest.

Figures

Fig. 1
Fig. 1
STROBE flow diagram. a Some patients met multiple exclusion criteria
Fig. 2
Fig. 2
Kaplan–Meier curves for time to revision surgery in patients with displaced FNF and undisplaced FNF. Log-rank test, p = < 0.001
Fig. 3
Fig. 3
Kaplan–Meier curves for time to revision surgery by indication for revision. Log-rank p < 0.001. AVN = avascular necrosis, PTOA = Posttraumatic osteoarthritis
See this image and copyright information in PMC

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