1. The treatment of femoral neck fractures and the results of the Gannet keynote session Hip # 2 lecture # O244 Ariaan van Walsum trauma surgeon Medisch Spectrum Twente Enschede The Netherlands & W. Roerdink, J. Vroemen, H. Janzing, T. Winkelhorst

2. C ONFLICT OF I NTEREST D ISCLOSURE F ORM NAME: ADP van Walsum AFFILIATION: Medisch Spectrum Twente, Enschede, The Netherlands DISCLOSURE I have the following potential conflict(s) of Interest to report: Type of affiliation / financial interest Name of commercial company Receipt of grants/research supports - Receipt of honoraria or consultation fees - Participation in a company sponsored speaker’s bureau - Stock shareholder Gannet Implant BV Spouse/partner - Other support (please specify) -

3. Treatment of femoral neck fractures 35% REVISION RATE IN DISPLACED # 11% IN UNDISPLACED #

4. Treatment of femoral neck fractures We got a problem!

5. Biology BIOLOGY IS THE MOTHER OF ALL FIXATION G.R. Girdlestone

6. Biology Achilles heel 1Bone healing No cambium layer No periosteal callus Primary bone healing Requires: – Anatomical reduction – Absolute stability

7. Biology Achilles heel 2Viability Remaining vascularisation – Reduction – Fixation Revascularisation: – Fixation stability – Implant volume

8. No angular stability No rotational stability Why do implants fail? multiple parallel screws or pins

9. Why do implants fail? sliding hip screw devices No rotational stability – During insertion – After insertion – +/- anti-rotation screw High implant volume

10. Can we make a better implant?

11. Dynamic Locking Blade Plate “GANNET” CHARACTERISTICS: Rotational stability Angular stability Dynamic compression Minimal invasive

12. GANNET example Trauma female 57 year

13. GANNET example 3 year

14. GANNET Failure Rate 3,9% for undisplaced fractures – N = 149 – Mean age 69 yrs 13,5% for displaced fractures – N = 192 – Mean age 61 yrs 60% for displaced unreduced fractures – N = 5

15. CONCLUSION femoral neck fractures AWARENESS! Indications for Gannet: – Undisplaced fractures all ages – Displaced fractures young patients (< 65) young elderly patients (65 – 75) – individualized on the biology – after anatomical reduction high risk elderly patients (> 75)

16. GANNET the bird… BG: Бял рибояд CZ: Terej bílý DE: Basstölpel DK: Sule FI: Suula EE: Sool ES: Alcatraz FO: Súla FR: Fou de Bassan HU: Szula IS: Súla IT: Sula bassana NL: Jan-van-gent NO: Havsule PL: Głuptaków PT: Ganso-patola RO: Corbul de mare RU: Северная олуша SE: Havssula UK: Gannet THANK YOU!