Vertical Femoral Neck Fractures in Young Adult Patients

NCT ID: NCT04687592

Last Updated: 2020-12-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

30 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-06-30

Study Completion Date

2023-09-30

Brief Summary

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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

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* 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.

Conditions

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Femoral Neck Fractures

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Interventions

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reduction and fixation

* Reduction: one trial of closed reduction under anaesthesia and image control. Open reduction will be done by anterolateral or lateral approach if closed reduction failed
* Fixation: internal fixation of the fracture by appropriate implant according to the fracture state

Intervention Type PROCEDURE

Eligibility Criteria

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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.
Minimum Eligible Age

20 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Thomas Magdi Labieb

resident at orthopedic department

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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thomas magdi labieb

Role: CONTACT

Phone: +201274638308

Email: [email protected]

References

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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.

Reference Type BACKGROUND
PMID: 17899921 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 11433141 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 26488776 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 24096307 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 25148589 (View on PubMed)

Other Identifiers

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Femoral Neck Fractures

Identifier Type: -

Identifier Source: org_study_id