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Review
. 2024 Nov 15:15:21514593241273326.
doi: 10.1177/21514593241273326. eCollection 2024.

Evaluation of Post-Operative Outcomes of Femoral Neck Fracture Interventions: A Systematic Review

Erin Sheffels  1 , Mariam Khalil  2 , Kristen Hutchison  2 , Nicole J Hardy  2 , Ranita Tarchand  2 , John M Pederson  1   2 , Anjani Parikh  3 , Michael Blauth  4
Affiliations
Review

Evaluation of Post-Operative Outcomes of Femoral Neck Fracture Interventions: A Systematic Review

Erin Sheffels et al. Geriatr Orthop Surg Rehabil. .

Abstract

Introduction: Femoral neck fractures (FNF) represent a significant challenge in orthopedic practice, demanding prompt intervention to restore function and mobility in affected individuals. Numerous surgical interventions have been developed to address these fractures, including internal fixation with devices such as the Femoral Neck System (FNS, DePuy Synthes, Inc., West Chester, PA, USA). However, the optimal fixation system remains unclear. Understanding the postoperative outcomes associated with these interventions is crucial for optimizing patient care and informing treatment decisions.

Significance: This PRISMA-compliant systematic literature review evaluates the efficacy and safety of the Femoral Neck System relative to other operative treatment options. Clinical and safety outcomes included mortality, perioperative complications, postoperative complications at 1 year, and reoperation.

Results: A total of 117 studies with 68,567 patients with FNF treated with internal fixation were identified. Of these, thirteen included FNS as a treatment arm (1078 patients). Due to heterogeneity in study designs and populations, only the eleven studies that directly compared FNS to other operative treatments, and 2 non-comparative studies that treated with FNS were included in the systematic review. Seven of the eleven included studies had high risk of bias, 2 had moderate risk of bias, and 2 had low risk of bias. FNS groups had similar or significantly lower incidences of postoperative complications, reoperations, and mortality compared to cannulated screw, cancellous screw, or dynamic or sliding hip screw groups in all studies.

Conclusion: FNS can be a safe and effective operative treatment option for FNF. Safety outcomes and reoperation rates are comparable between patients treated with FNS and patients treated with cannulated screws, cancellous screws, and dynamic or sliding hips screws. Future prospective, controlled studies are needed to confirm the safety and efficacy of FNS relative to other operative treatment options.

Keywords: dynamic screws; femoral neck fracture; femoral neck system; hip fracture.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: ES is employed by and hold equity in Superior Medical Experts. JMP is employed by and hold equity in Superior Medical Experts and Nested Knowledge. MK and RT are employed by Nested Knowledge. KH is employed by Superior Medical Experts and Nested Knowledge. NJH is employed by and holds equity in Nested Knowledge. AP and MB are employed by Johnson & Johnson (JnJ) and own stock in the company.

Figures

Figure 1.
Figure 1.
Three dimensional models of the FNS device. Used with permission.
Figure 2.
Figure 2.
PRISMA study selection flowchart.
See this image and copyright information in PMC

References

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    1. DePuy Synthes Report: Static Cut through Rotation Test in Bone Foam. DePuy Synthes; 2016:0000165855.

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