High Complication Rate After Percutaneous Screw Fixation for Valgus-Impacted Femoral Neck Fractures Without Sagittal...

Area of Science:

• Orthopedic surgery
• Trauma surgery
• Biomedical engineering

Background:

• Femoral neck fractures are common in elderly patients.
• Valgus-impacted fractures require specific fixation strategies.
• Percutaneous screw fixation is a minimally invasive option.

Purpose of the Study:

• Evaluate reoperation rates after percutaneous screw fixation for valgus-impacted femoral neck fractures.
• Assess major complication rates in this patient cohort.
• Compare fixation strategies and implant types.

Main Methods:

• Retrospective case series at two Level 1 trauma centers.
• Included 207 patients over 50 years with valgus-impacted femoral neck fractures.
• Excluded patients with sagittal plane deformity.

Main Results:

• 15% of patients required reoperation; 17.3% experienced major complications.
• All partially threaded screws correlated with higher reoperation risk (17.0% vs 7.5%).
• Inverted triangle configuration with at least one fully threaded screw showed better outcomes.

Conclusions:

• Percutaneous screw fixation for these fractures has a high reoperation and complication rate.
• Screw configuration and thread type significantly impact outcomes.
• Further research into optimal fixation is warranted.