FNS implant a minimally invasive alternative to DHS in treatment of femur neck fractures

Written By : Dr Supreeth D R |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-12-28T20:00:59+05:30 | Updated On 28 Dec 2022 8:01 PM IST

Amit Davidson et al study showed that FNS is a safe treatment option for femoral neck fractures (FNF). Intra-operative parameters and failure rates are comparable to other frequently used implants. The study has been published in "International Orthopaedics" journal.

The recently developed femoral neck system (FNS) (DePuy Synthes, Raynham, MA, USA) for treatment of femoral neck fractures (FNF), comprises theoretical biomechanical advantages of combining compression and anti-rotation qualities during internal fixation. The effective solution the FNS design provides, involves the screw-plate construct, allowing stronger fixation, as well as a combination of blade and anti-rotation screw, that improves axial and rotational stability. Biomechanical studies have shown axial and rotational stability superiority of FNS implant over the traditional cannulated screws (CS) and the dynamic hip screw (DHS).

Amit Davidson et al conducted a retrospective multicentric analysis of patients treated by FNS with a minimum of three months of follow-up. Details analysed from three medical centres were operative duration, estimated blood loss, initial hospitalisation duration, fixation quality as well as complications and reoperation rate. Patients who had revision surgery were compared to all other patients to identify risk factors for failure. In addition, a literature review was performed to analyse data on FNS clinical implementation and patient's outcomes. The two data sets were combined and analysed.

The results of the study were:

• One-hundred and two patients were included in this study cohort with an average follow-up of seven months (range 3–27).

• Ten papers were included in the literature review, reporting data on 278 patients. Overall, 380 patients were analysed.

• Average age was 62.6 years, 52% of the fractures were classified as Gardens 1–2.

• The average estimate blood loss for the FNS procedure was 47 (ml), an estimate, which is in the lower reported range for similar procedures.

• The average operative time was 44 (range 21–95) minutes. The reported short operative time can be attributed to the low number of surgical steps in FNS which enhances procedural efficiency.

• Overall, the revision rate was 9.2% (14 patients diagnosed with cut-out of implant, 10 with AVN, 8 with non-union and 8 with hardware removal).

• For the 102 patients in the cohort risk factors for reoperation included patients' age, surgeon seniority and inadequate placement of the implant.

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751