Clinical trial NCT04687592: Vertical Femoral Neck Fractures in Young Adult Patients
Official title: Radiological and Functional Outcomes of Internal Fixation Methods for Vertical Femoral Neck Fractures in Young Adult Patients
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Femoral Neck Fractures
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2020-12-29
Enrollment: 30
Sex: ALL
Minimum age (years): 20
Maximum age (years): 50
Standard ages: ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: adults patients with recent vertical femoral neck fracture

Brief summary: Does the current techniques of internal fixation of vertical neck fracture in young adult patients give a satisfactory radiological and functional outcome at one year follow up?

Detailed description: * Displaced femoral neck fractures in young adults are most likely to result from high energy trauma that causes a vertically-oriented shearing injury through the femoral neck.
* The most descriptive classification used for femoral neck fractures in young patients is the Pauwels classification. As the degree of the femoral neck fracture line relative to the horizontal plane increases, the types differ (30 degrees type I, between 30 degrees and 50 degrees type II, 50 degrees type III), and the instability of the fracture.
* Greater fracture verticality contributes to greater difficulty in obtaining adequate stability to resist vertical shear forces around the hip, thereby resulting in ascending greater risk of complications such as nonunion and osteonecrosis despite a number of potential fixation strategies.
* The primary goals of surgery include preservation of the femoral head, avoidance of osteonecrosis, and achievement of a stable union.
* Fixation options include cannulated screws, sliding hip screw with or without an additional derotation screw,. among orthopedic trauma surgeons there is no consensus that a single fixation Option is superior for treating these injuries.

Eligibility criteria: Inclusion Criteria:

* Age of the patients from 20 to 50 years

  * Pauwel type III fractures
  * Recent fracture within one week

Exclusion Criteria:

* • Open fractures

  * Pathological or osteoporotic fractures.
  * Patient with comorbidities: D.M, renal patient, neurological deficits.
  * Patient associated with femoral head fractures or head impaction.

Primary outcomes:
measure: radiological and functional evaluation of the time and rate of union according harris hip score
timeFrame: one year
Secondary outcomes:
Other outcomes:
Locations:
Study officials:
References:
citation: Macaulay W, Yoon RS, Parsley B, Nellans KW, Teeny SM; DFACTO Consortium. Displaced femoral neck fractures: is there a standard of care? Orthopedics. 2007 Sep;30(9):748-9. doi: 10.3928/01477447-20070901-08.
citation: Bartonicek J. Pauwels' classification of femoral neck fractures: correct interpretation of the original. J Orthop Trauma. 2001 Jun-Jul;15(5):358-60. doi: 10.1097/00005131-200106000-00009.
citation: Ye Y, Hao J, Mauffrey C, Hammerberg EM, Stahel PF, Hak DJ. Optimizing Stability in Femoral Neck Fracture Fixation. Orthopedics. 2015 Oct;38(10):625-30. doi: 10.3928/01477447-20151002-05.
citation: Collinge CA, Mir H, Reddix R. Fracture morphology of high shear angle "vertical" femoral neck fractures in young adult patients. J Orthop Trauma. 2014 May;28(5):270-5. doi: 10.1097/BOT.0000000000000014.
citation: Luttrell K, Beltran M, Collinge CA. Preoperative decision making in the treatment of high-angle "vertical" femoral neck fractures in young adult patients. An expert opinion survey of the Orthopaedic Trauma Association's (OTA) membership. J Orthop Trauma. 2014 Sep;28(9):e221-5. doi: 10.1097/BOT.0000000000000080.