Key result
Use of double-fluoroscopy during cannulated screw fixation for femoral neck fractures significantly reduced the mean duration of surgery by 14.2 minutes compared to single-fluoroscopy.
Why the study?
Single-fluoroscopic guidance during osteosynthesis for femoral neck fractures requires continuous repositioning to obtain biplane imaging, motivating an evaluation of whether double fluoroscopy improves radiation safety and treatment parameters.
Does double-fluoroscopy reduce surgical duration and radiation exposure compared to single-fluoroscopy in patients undergoing osteosynthesis for femoral neck fractures?
Cohort (n=35)
Does double-fluoroscopy reduce surgical duration and radiation exposure compared to single-fluoroscopy in patients undergoing osteosynthesis for femoral neck fractures?
Mean Difference: -14.2
Absolute Event Rate: 37.7% vs 51.9%
p-value: p=0.001
The use of double-fluoroscopy during osteosynthesis for femoral neck fractures significantly reduces both surgical duration and radiation exposure compared to single-fluoroscopy.
May shorten operative time in femoral neck fixation; hypothesis-generating pending randomized confirmation of radiation and outcome benefits.
PURPOSE OF THE STUDY The most commonly used technique for fixation of the femoral neck fractures is percutaneous osteosynthesis with cannulated screw under fluoroscopy guidance. Osteosynthesis performed under single-fluoroscopic guidance requires continuous repositioning the fluoroscope to obtain biplane imaging. This study aimed to evaluate whether there is a statistically significant difference between the osteosynthesis procedures performed under guidance of single-fluoroscopy and double fluoroscopy with respect to radiation emission safety and treatment parameters for fixation of femoral neck fractures. MATERIAL AND METHODS This retrospective study included 35 patients operated for femoral neck fracture between December 2013 and October 2017. Osteosynthesis was performed in 21 of these patients using cannulated screw under guidance of single-fluoroscopy whereas other 14 patients underwent same type of osteosynthesis assisted by double-fluoroscopy. The parameters of these two groups such as duration of surgery preparation, duration of the surgery, duration of radiation exposure, collo-diaphyseal angle and Harris hip score values were recorded. RESULTS No significant difference was found between the groups regarding time for surgery preparation (p > 0.05). On the other hand, duration of surgery and overall duration of radiation exposure were found 14 (p < 0.05) and 15 (p < 0.05) minutes shorter in the double-fluoroscopy group, respectively. No significant difference was found between the groups in terms of collo-diaphyseal angle and Harris hip score values (p > 0.05). CONCLUSIONS Use of double-fluoroscopy significantly reduces time of surgical duration and also level of radiation exposure in surgery of femoral neck fractures.
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Gülenç et al. (2019) conducted a cohort in Femoral neck fractures (n=35). Double-fluoroscopy guidance vs. Single-fluoroscopy guidance was evaluated on Duration of surgery (minutes) (14.2 minutes shorter, p=0.001). Use of double-fluoroscopy during cannulated screw fixation for femoral neck fractures significantly reduced the mean duration of surgery by 14.2 minutes compared to single-fluoroscopy.
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