ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2020
High incidence of "in-out-in" posterosuperior screws after cannulated screw fixation of femoral neck fractures.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 14 citations in OpenAlex.
- Identification of optimal screws positions for internal fixation of femoral neck fracture: A simulation study based on femoral neck safe zone.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2026Article
- Biomechanical and clinical evaluation of the posterosuperior screw in-out-in in the inverted triangular cannulated screws fixation of femoral neck fractures.Frontiers in bioengineering and biotechnology · 2026Article
- [Analysis of effectiveness of Holosight robot navigation-assisted percutaneous cannulated screw fixation in treatment of femoral neck fractures].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025Article
- Intraoperative angulation of the C-arm for X-ray of each curved surface of the femoral neck wall: a cadaveric study.BMC musculoskeletal disorders · 2024Article
- A Novel Navigation Device for Precise Percutaneous Placement of the Guidewire in Femoral Neck Fracture Cannulated Screw Fixation Surgery.IEEE journal of translational engineering in health and medicine · 2024Article
- Can "In-Out-In" posterosuperior screws meet nutrient foramina in patients with femoral neck fractures?Journal of orthopaedic surgery and research · 2023Article
- A new posterosuperior screw placement strategy to avoid in-out-in screws in femoral neck fractures.Frontiers in surgery · 2023Article
- The application of the 150° oblique tangential fluoroscopic view to detect the posterosuperior femoral neck screw in-out-in intraoperatively.Scientific reports · 2022Article
- In-out-in screws in femoral neck fractures: Can they be avoided?European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2022Article
- Modified radiographic views to prevent the anterosuperior and posterosuperior bony violation during screw fixation of femoral neck fractures.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2021Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCadaveric models have demonstrated a high incidence of extraosseous "in-out-in" (IOI) posterosuperior screws after cannulated screw fixation of femoral neck fractures. The purpose of this study was to determine the incidence of IOI screws in vivo and to evaluate their association with osteonecrosis and revision surgery.
methodsA total of 104 patients with 107 hips with a pelvis computed tomography (CT) scan after cannulated screw fixation of a femoral neck fractures were included. Screw position was evaluated on postoperative radiographs and CT scan to determine if screws were IOI or all-in. Osteonecrosis and revision surgeries were documented.
resultsIOI posterosuperior screws were identified on CT scan in 58 (54%) hips. On postoperative AP and lateral radiographs, IOI screws were a median (interquartile range) of 10 mm (7-11 mm) and 3 mm (0-4 mm) from the cortex, respectively. The sensitivity and specificity of radiographs to detect IOI screws was 39% and 92%, respectively. The incidence of osteonecrosis and revision surgeries in hips, with and without IOI screws, was 6% versus 6% [Odds ratio (OR) 1.1, 95% confidence interval (CI) 0.2-5.3] and 10% versus 10% (OR 1.0, CI 0.3-3.1), respectively; a true clinical difference cannot be excluded due to the width of the confidence intervals.
conclusionsThere was a high incidence of IOI posterosuperior screws on CT scans. Postoperative radiographs had a poor sensitivity for detecting IOI screws. A larger sample size is necessary to evaluate the association of IOI screws with osteonecrosis and revision surgery. LEVEL OF EVIDENCE: Level III, comparative cohort study.
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