Femoral Neck Open Reduction And Internal Fixation

Josh Tadlock,MD

Content Contributor

Evolution of Femoral Neck Open Reduction And Internal Fixation

Historically they have treated with independent screws placed into the femoral neck, but this provides no compression to encourage bone healing. There have also been many plating systems, but these often require a large dissection that can put the blood supply to the femoral head at risk and may hasten osteonecrosis (bone death due to a lack of blood supply).

Soon there were specific plates like the Dynamic Hip Screw (DHS) that were used to provide compression across the fracture site to encourage bone healing. However, these had poor rotational control because the fragment in the hip joint could still rotate independently as the screw was advanced.

Technology Spotlight

Depuy Synthes Femoral Neck System (FNS)

The Femoral Neck System was designed by Depuy Synthes to address some of these challenges. It is a plate and screw system that was specifically engineered for femoral neck open reduction and internal fixation. It has a large diameter “bolt” that provides angular stability. There is an anti-rotational screw that allows for rotational control of the femoral head fragment.

It has a low-profile design to prevent hardware prominence and an option to place 1 or 2 independent screws to help secure the plate to the femur. It only requires a small incision on the hip that allows for preservation of the blood supply that keeps the femoral head alive. This system allows for an anatomic reduction of the femoral neck, while providing built-in options to also control rotation in a low-profile design, all while respecting the blood supply to the femoral head.