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Evaluation of BDSF in FNFPhase 2RCTNCT07896031

BDSF Vs DHS With Anterotational Screw in Vertical FNF

A Phase 2 study testing Dynamic Hip Screw with Anterotation Screw Fixation and Biplane Double-Supported Screw Fixation in people with Evaluation of BDSF in FNF, run by Ain Shams University at 1 site in Egypt.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

Pauwels type III femoral neck fractures in young adults commonly result from high-energy trauma and are characterized by a vertical fracture orientation with substantial shear and rotational forces. Read more about this study

Who is it for?
Ages 16 to 60 years
Conditions the study is for
Evaluation of BDSF in FNF
What is being tested?
Dynamic Hip Screw with Anterotation Screw Fixation and Biplane Double-Supported Screw Fixation
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteEgypt
Study dates
1 Sep 2024to 1 May 2027
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 16 to 60 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Pauwels type III vertical femoral neck fracture
  • Isolated femoral neck fracture
  • Age between 18 and 50 years, inclusive

Who cannot join

  • Pauwels type I or type II femoral neck fracture
  • Associated pelvic ring or acetabular fracture requiring intervention
  • Associated lower-extremity fracture requiring intervention
  • Femoral neck fracture more than 14 days old
  • Pathological fracture
  • Age younger than 18 years or older than 50 years

Trial locations and contacts

1 site in 1 country.

Egypt1 site
  • Ain Shams University

    Cairo, Abassia, 1234

Other trials in Egypt

About this study

Official title: Biplane Double Support Screw Fixation Versus Sliding Hip Screw With Antirotation Screw in Management of Pauwels Type III Neck of Femur Fractures in Young Adults: A Randomized Controlled Trial

Pauwels type III femoral neck fractures in young adults commonly result from high-energy trauma and are characterized by a vertical fracture orientation with substantial shear and rotational forces. These fractures are associated with an increased risk of mechanical instability, nonunion, varus collapse, fixation failure, and osteonecrosis of the femoral head. Successful treatment therefore requires anatomical reduction and stable internal fixation capable of resisting both vertical shear and rotational forces.

A Sliding Hip Screw combined with an antirotation screw provides controlled fracture compression and additional rotational stability. Biplane Double Support Screw Fixation is an alternative technique in which cannulated screws are inserted in two planes to provide double cortical support. The distal screw entry points and calcar-supported configuration are intended to distribute axial loading toward the femoral diaphysis, improve mechanical stability, facilitate fracture impaction, and reduce the risk of varus collapse.

Read more

This prospective randomized controlled study will compare Biplane Double Support Screw Fixation with Sliding Hip Screw fixation combined with an antirotation screw in young adults with Pauwels type III femoral neck fractures. Participants will be randomly allocated in a 1:1 ratio to receive one of the two fixation techniques.

The study will compare fracture healing, functional recovery, radiological outcomes, and postoperative complications between the two groups. Particular attention will be given to nonunion, osteonecrosis of the femoral head, varus collapse, implant failure, and the need for additional surgery. The study hypothesis is that Biplane Double Support Screw Fixation may provide stable fixation with clinical and radiological outcomes comparable or superior to those achieved using a Sliding Hip Screw with an antirotation screw.

Read the detailed description

This prospective, randomized, controlled clinical study will be conducted at Ain Shams University Hospitals. Participants with acute Pauwels type III femoral neck fractures will be allocated in a 1:1 ratio using a computer-generated randomization table to undergo fixation using either Biplane Double Support Screw Fixation or a Sliding Hip Screw with an additional antirotation screw.

A minimum of 30 participants will be recruited, with 15 participants assigned to each treatment group. The sample size was calculated using a sample-size calculation program, with a two-sided alpha level of 0.05, statistical power exceeding 99%, and an anticipated dropout rate of 10%. The calculation was based on detecting a clinically meaningful difference in operative time between the two fixation techniques.

Preoperative assessment will include detailed history-taking, clinical examination, neurovascular evaluation of both lower limbs, and trauma assessment when clinically indicated. Radiographic evaluation will include an anteroposterior pelvic radiograph with both hips, a lateral radiograph of the affected hip, and radiographs of the entire femur and knee. Preoperative computed tomography of the pelvis will be performed when required to define the fracture configuration and assist surgical planning.

All procedures will be performed under anesthesia on a radiolucent operating table. Closed reduction will initially be attempted under fluoroscopic guidance. If satisfactory closed reduction cannot be achieved, open reduction will be performed through the Watson-Jones approach. A lateral approach will be used when adequate closed reduction is achieved.

Participants assigned to the first group will undergo Biplane Double Support Screw Fixation. Screws will be inserted in two supporting planes to provide fixation of the femoral neck fracture and resist vertical shear forces. Participants assigned to the second group will undergo fixation using a Sliding Hip Screw combined with an additional antirotation screw. Fluoroscopic anteroposterior and lateral views will be used intraoperatively to assess fracture reduction and implant position.

Postoperative management will be standardized for both groups. Antibiotic prophylaxis, thromboprophylaxis, analgesia, and neurovascular monitoring will be provided according to institutional protocols. Toe-touch weight bearing will be recommended during the first six postoperative weeks. Progressive partial weight bearing and physiotherapy will subsequently be initiated according to radiographic progression and fixation stability. Full weight bearing will generally be permitted after evidence of satisfactory fracture healing.

Clinical and radiographic follow-up will be performed at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months after surgery. Sutures will be removed at the 2-week visit, and passive and assisted active hip range-of-motion exercises will be initiated. Progressive weight bearing and strengthening exercises will begin during subsequent visits according to clinical and radiographic findings.

Data will be analyzed using the Statistical Package for the Social Sciences. Quantitative variables with a normal distribution will be summarized using means and standard deviations, while non-normally distributed variables will be presented using medians and interquartile ranges. Categorical variables will be summarized using frequencies and percentages. Appropriate statistical tests will be selected according to the type and distribution of the data. All statistical tests will be two-sided, and a P value of less than 0.05 will be considered statistically significant.

Written informed consent will be obtained from all participants before enrollment. The study will be conducted in accordance with applicable institutional ethical standards and will receive approval from the Faculty of Medicine, Ain Shams University Research Ethics Committee.

Being tested
Dynamic Hip Screw with Anterotation Screw Fixation, Biplane Double-Supported Screw Fixation
Keywords
Biplane double support, femoral neck fractures, Dynamic hip Screw, Pauwel angle, vertical fractures
Medical subject headings
Femoral Neck Fractures

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Dynamic Hip Screw with Anterotation Screw FixationProcedure or surgery

    nternal fixation of the femoral neck fracture using a dynamic hip screw with a side plate, supplemented with a parallel antirotation screw to improve rotational stability of the femoral head and neck fragment.

  • Biplane Double-Supported Screw FixationProcedure or surgery

    Internal fixation of the femoral neck fracture using three cannulated screws inserted according to the biplane double-supported screw fixation technique. The screws will be positioned in two oblique planes to obtain cortical support at the femoral neck and improve the biomechanical stability of the fracture fixation.

Study groups in NCT07896031
Study groupRoleWhat they receive
Fixation of Pauwel III femoral neck fractures via DHS and Anterotational ScrewActive comparatorDHS with anterotational screw for management of vertical femoral neck fractures as the standard of use
Receives: Procedure: Dynamic Hip Screw with Anterotation Screw Fixation
Fixation of Pauwel III femoral neck fractures via BDSFExperimentalWe used biplanar double support screw fixation for management of vertical femoral neck fractures
Receives: Procedure: Biplane Double-Supported Screw Fixation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Rates of nonunion

    Nonunion will be assessed using serial anteroposterior and lateral hip radiographs. It will be defined as failure of fracture healing with a persistent fracture line and absence of progressive trabecular or cortical bridging across the fracture site, with or without persistent pain during weight bearing, at 9 months after fixation. Cases requiring revision surgery for failure of fracture healing before the 9-month assessment will also be classified as nonunion. Radiographs will be independently evaluated by two orthopedic surgeons, with disagreements resolved by consensus. The nonunion rate will be calculated as the number of patients meeting the nonunion criteria divided by the total number of evaluable patients, multiplied by 100.

    Measured: up to 1 year postoperative

  2. Functional outcome assessed using the Harris Hip Score was evaluated and calculated at each follow-up visit, with the mean value presented

    Hip function will be evaluated using the Harris Hip Score (HHS), which assesses pain, function, absence of deformity, and hip range of motion. The total score ranges from 0 to 100 points, with higher scores indicating better hip function. Results will be classified as excellent (90-100), good (80-89), fair (70-79), or poor (<70). The mean HHS and the proportion of patients within each functional category will be reported.

    Measured: At 3, 6, and 12 months after surgery.

  3. Rate of osteonecrosis of the femoral head

    Osteonecrosis of the femoral head will be assessed using serial anteroposterior and lateral hip radiographs. Diagnosis will be based on the development of characteristic radiographic changes, including femoral head sclerosis, cystic changes, subchondral collapse, crescent sign, or loss of femoral head sphericity. Magnetic resonance imaging will be performed when osteonecrosis is clinically suspected but not confirmed on plain radiographs. Osteonecrosis will be classified according to the Association Research Circulation Osseous (ARCO) classification. Patients who undergo revision surgery or conversion to hip arthroplasty because of osteonecrosis will be considered to have reached the outcome. The osteonecrosis rate will be calculated as the number of patients diagnosed with osteonecrosis divided by the total number of evaluable patients, multiplied by 100.

    Measured: Up to 12 months after surgery.

Secondary outcomes (3)
  1. Mean Operative Time

    The mean operation time was calculated and compared between the two study groups

    Measured: It was calculated intra-operative

  2. Mean Intraoperative Blood Loss

    The mean blood loss was calculated and compared between the two study groups; it was measured intraoperatively and postoperative from suction drains

    Measured: Up to 4 days postoperative

  3. Need For Another Operations' Rate

    The need for another operation was observed and compared between the two study groups

    Measured: Through study completion, an average of 1 year postoperative

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Oct 2026
  2. Study start1 Sep 2024
  3. Primary completion1 Mar 2027 (estimated)
  4. Study completion1 May 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
An independent doctor created the randomization sequence using Excel 2016 (computerized random numbers) with a 1:1 allocation via random block sizes of 2, 4, and 6; he assigned the sample numbers equally to each group and assigned the block. Patients and physicians allocated to each intervention group were aware of the allocation; however, the data analysts and the outcome assessors were kept blinded to the allocation. We prospectively carried out this study on 30 patients with Pauwel III femoral neck fractures between september 2024 and july 2026 that met our inclusion criteria. The independent doctor allocated the 30 cases to two groups: Group A (15 cases): Biplane Double Support Screw fixation (BDSF fixation group) , group B (15 cases): Dynamic Hip Screw (DHS with Anterotational screw group).
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
30 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07896031
Sponsor's protocol ID
FMASU R191/2024
Acronym
RCT
Status last verified
Oct 2026
First submitted
18 Oct 2026
Last updated
26 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Dynamic Hip Screw with Anterotation Screw Fixation and Biplane Double-Supported Screw Fixation in people with Evaluation of BDSF in FNF, run by Ain Shams University at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 26 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Rates of nonunion (time frame: up to 1 year postoperative). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Oct 2026.

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