A Prospective Multicenter Cohort Study About Internal Fixation Using FNS Versus MCS for Femoral Neck Fracture
A Prospective Multicenter Cohort Study About Internal Fixation Using Synthes Femoral Neck System (FNS) Versus Multiple Cancellous Screws (MCS) for Femoral Neck Fracture
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Xiangyu Xu, MD
- Phone Number: +86-15210849431
- Email: 307542744@qq.com
Study Locations
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Beijing Municipality
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Beijing, Beijing Municipality, China, 100191
- Peking University Third Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥18 years
- Patients with unilateral femoral neck fractures that will be treated with internal fixation
- According to AO fracture classification, subjects with the fracture type (31-B)
- Subjects (with the help of relatives) can understand the informed documents and patient questionnaires.
- Subjects (with the help of relatives) voluntarily provide written informed consent to participate in the clinical study and authorize the transfer of their information to the sponsor.
- The investigator believes that the subject can understand the clinical study, is willing and able to complete all research procedures and follow-up visits and can cooperate with the research procedures.
- In-label use of the MCS and FNS.
Exclusion Criteria:
- Subject does not provide voluntary consent to participate in the study.
- The researcher believes that the subjects have conditions that affect the participation and follow-up of this study. (for example, the patient lives in a remote area or has difficulty in going back to the hospital for follow-up or does not cooperate with the medical guidance and suggestions of the surgeon.)
- The subjects were pregnant or lactating women.
- The researchers believe that the subjects have psychological disorders, which may affect the treatment outcome.
- Garden classification III and IV of femoral neck fracture patients older than 65 years
- Concurrent hip osteoarthritis.
- Fractures where the operative treatment will occur more than three weeks after the primary injury
- Patients combined with other bone fractures.
- Pathological fracture (e.g., primary or metastatic tumor)
- Serious soft tissue injury, judged by the investigator, will impact the union of the fracture, combined open fractures, vascular injury, and combined osteofascial compartment syndrome
- Multiple systemic injuries judged by researchers not suitable for enrollment.
- Revision surgeries (for example, due to malunion, nonunion or infection)
- Concurrent medical conditions judged by researchers not suitable for enrollment, such as: metabolic bone disease, post-polio syndrome, poor bone quality, prior history of poor fracture healing, etc
- Patients with anaesthetic and surgical contraindications
- Patients known to be allergic to implant components
- Patients who are currently using chemotherapeutics or accepting radiotherapy, use systematically corticosteroid hormone or growth factor, or long-term use sedative hypnotics (continuous use over 3 months) or non-steroidal anti-inflammatory drugs (continuous use over 3 months)
- Intemperance judged by researchers not suitable for enrollment (e.g., excessive daily drinking or smoking, drug abuse);
- Subjects participated in other clinical studies in the past 3 months, which may affect the outcome and follow-up according to the judgment of researchers.
- Subjects have significant neurological or musculoskeletal disorders or may have adverse effects on gait or weight-bearing (e.g., muscular dystrophy, multiple sclerosis, cerebral infarction, hemiplegia, Charcot arthropathy, avascular necrosis of the femoral head).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Experimental: Synthes Femoral Neck System (FNS)
Synthes Femoral Neck System (FNS) was developed with the intention to combine advantages of DHS (dynamic hip screw) and MCS (multiple cancellous screw).
The FNS implants consist of plates, bolts, locking screws and antirotating-screws.
The plate consists of a small base plate with one or two locking holes and a barrel portion.
The barrel allows for gliding of the head elements while restricting rotation around the head-neck axis, so FNS is a fixed-angle gliding fixation device that allows for controlled collapse of the femoral neck, like DHS.
The FNS was also designed to minimize implant footprint on the bone with its compact design, like MCS.
Furthermore, the FNS was designed to reduce the length of incision necessary for implant insertion when compared to DHS.
This new concept of femoral neck fracture fixation still emphasizes the biology of fracture healing by initial fracture compression.
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perform preoperative preparation, intraoperative operation and internal fixation implantation according to the instructions provided in the product packaging.
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Active Comparator: Multiple cancellous screws (MCS)
Multiple cancellous screws (MCS) fixation is the most common and classic method to deal with femoral neck fractures which is less invasive and retains more viable bone, compared with dynamic hip screw (DHS) fixation that appears biomechanically more stable.
In this study, three cancellous screws with an inverted triangle pattern are used to fix the fracture of femoral neck.
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three cancellous screws with an inverted triangle pattern are used to fix the fracture of femoral neck.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Internal Fixation Failure Rate
Time Frame: from operation to 1-year follow-up after the surgery
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defined as the total incidence of internal plant cut-out and fracture.
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from operation to 1-year follow-up after the surgery
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Number of Participants With Bone Nonunion
Time Frame: from operation to 1-year follow-up after the surgery
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evaluate bone healing according to the lateral X-ray examination.
According to the regulations of Food and Drug Administration of the US, if there are no obvious signs of fracture healing 9 months after the fracture, or if there is no obvious difference in fracture space after three consecutive months, it is defined as nonunion.
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from operation to 1-year follow-up after the surgery
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Harris Hip Score
Time Frame: At 1 year after the surgery
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the scale of the score value is from 0 to 100, and a higher score means a better outcome
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At 1 year after the surgery
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Operation Time
Time Frame: intraoperative
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from the incision to internal fixation implanted.
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intraoperative
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The Times of Intraoperative Fluoroscopy
Time Frame: intraoperative
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average 25 milliseconds per X-ray shot, record the number of X-ray shot
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intraoperative
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Number of Participants With Postoperative Adverse Events
Time Frame: from operation to 1-year follow-up after the surgery
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including ipsilateral femoral head avascular necrosis, infection, wound hematoma, ipsilateral coxa vara, and ipsilateral limb shortening
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from operation to 1-year follow-up after the surgery
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Reduction Quality
Time Frame: from operation to 1-year follow-up after the surgery
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Routine radiographs were taken to assess fracture reduction quality, which was categorized neutral, positive or negative support.
Neutral Support: the medial cortex of the head-neck fragment is continuous with the medial cortex of the femoral shaft.
Positive support: the medial cortex of the head-neck fragment lies medial to the medial cortex of the femoral shaft.
Negative support: the medial cortex of the head-neck fragment lies lateral to the medial cortex of the femoral shaft.
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from operation to 1-year follow-up after the surgery
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Femoral Neck Shortening
Time Frame: from operation to 1-year follow-up after the surgery
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Since both implants are designed to allow for femoral neck shortening to allow fragment contact and bone healing.
The amount of shortening primarily depends on the fracture configuration and bone quality.
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from operation to 1-year follow-up after the surgery
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Director: Fang Zhou, MD, Peking University Third Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- PekingUTH ZF FNS
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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