Advances on preventing femoral neck shortening after internal fixation of femoral neck fracture

Abstract

Femoral head necrosis and nonunion is a common complication after surgery of femoral neck fracture. Recently, femoral neck shortening have caused attentions which can impact the function of hip. Incidence,mearsurement,influence factor, prevention and treatment of femoral neck shortening have been retrospective reviewed. Amount of femoral neck shortening with sliding compression system is significantly more than length of stability system, which is result from its own mechanism. However, effcacy of length of stability system still need a large scale of sample. It uses radiography to diagnose shortening. The present measurement methods include displacement of femoral head, xyz-axis measurement, the length of exposed screw, the collapse of femoral head. However, position, the angle of screen and the defect of the method would increase deviation. A measurement with simple, wide application and accuracy need to continue to explore. Apart from patients' condition, shortening also affected by the pattern and quality of surgery. Overall, older women, displacement fracture, unsatisfactory reduction will increase the risk and shrinkage of shortening. In addition, the pattern of the internal fixation becomes the research focus in the field of orthopedic clinical research. Including the transformation of sliding compression system device and design of novel device. How to combine them together organically could be a future development direction. Meanwhile, there are still in exploratory stage to decide whether biological combined with internal fixation can prevent shortening. Intertrochanteric osteotomy can achieve union and correct the limb-length discrepancy, However, it did not restore the length of femoral neck. So, it is unknown that whether the method can solve the slight shortening which have impacted the hip function.