The Application of a Noninvasive Extracapsular Traction Reduction Technique in Valgus-Impacted Femoral Neck Fracture:...

Reduction of valgus-impacted femoral neck fractures remains a major challenge for orthopedic surgeons. Most reduction techniques require extensive surgical experience, and intraoperative reduction evaluation standards do not exist. The aim of this study is to report the use of a noninvasive extracapsular traction reduction technique for valgus-impacted femoral neck fractures and our innovative use of a smartphone application to evaluate reduction outcomes.

We conducted a retrospective study on patients with valgus-impacted femoral neck fractures who underwent the noninvasive extracapsular traction reduction technique at a hospital between December 2022 and January 2024. General medical records from the preoperative, intraoperative, and postoperative periods were collected, with particular emphasis on evaluating intraoperative reduction effectiveness. The primary reduction indicator was the reduction angle (RA). The principal functional assessment indicator was the Harris Hip Score (HHS).

Radiographic measurements demonstrated significant differences between preoperative and postoperative RAs on the affected side (p < 0.05), while no differences in the RAs were observed between the unaffected side and postoperative affected side (p > 0.05). No statistically significant difference was detected between the intraoperative and postoperative radiographic measurements of the RAs on the affected side (p > 0.05). The follow-up period ranged from 12 to 25 months, with a mean duration of 17.7 ± 3.5 months. Preoperative HHS averaged 37.9 ± 5.2 points, increasing to 88.7 ± 4.1 points at final follow-up. Both 6-month and 1-year postoperative HHS showed significant improvement compared to preoperative values (p < 0.05). No fixation failure was observed during the follow-up, with a radiographic failure rate of 0% at final assessment.

For valgus-impacted femoral neck fractures, the bone hook-assisted noninvasive extracapsular traction reduction technique can achieve optimal reduction without causing intraarticular cartilage damage. The RA helps evaluate the quality of intraoperative reduction. ImageMeter can be an effective tool for evaluating fracture reduction intraoperatively.