-A machine learning model to predict surgical site infection after surgery of lower extremity fractures.

PURPOSE: This study aimed to develop machine learning algorithms for identifying predictive factors associated with the risk of postoperative surgical site infection in patients with lower extremity fractures. METHODS: A machine learning analysis was conducted on a dataset comprising 1,579 patients who underwent surgical fixation for lower extremity fractures to create a predictive model for risk stratification of postoperative surgical site infection. We evaluated different clinical and demographic variables to train four machine learning models (neural networks, boosted generalised linear model, naïve bayes, and penalised discriminant analysis). Performance was measured by the area under the curve score, Youdon's index and Brier score. A multivariate adaptive regression splines (MARS) was used to optimise predictor selection. RESULTS: The final model consisted of five predictors. (1) Operating room time, (2) ankle region, (3) open injury, (4) body mass index, and (5) age. The best-performing machine learning algorithm demonstrated a promising predictive performance, with an area under the ROC curve, Youdon's index, and Brier score of 77.8%, 62.5%, and 5.1%-5.6%, respectively. CONCLUSION: The proposed predictive model not only assists surgeons in determining high-risk factors for surgical site infections but also empowers patients to closely monitor these factors and take proactive measures to prevent complications. Furthermore, by considering the identified predictors, this model can serve as a reference for implementing preventive measures and reducing postoperative complications, ultimately enhancing patient outcomes. However, further investigations involving larger datasets and external validations are required to confirm the reliability and applicability of our model.

Risk factors for malalignment after intramedullary nail treatment of distal tibia fractures with associated fibula fractures.

PURPOSE: Malalignment of distal tibia fractures can lead to malunion/nonunion or alter the limb mechanical axis which may cause arthritis. Proposed methods to decrease malalignment include fibular fixation or multiplanar interlocking screws, however these remain controversial. This study aimed to identify factors associated with malalignment in distal tibial fractures with associated fibular shaft fractures. METHODS: A retrospective review was performed of distal tibia fractures with associated fibular shaft fractures treated with intramedullary nailing at two level one trauma centers between 2015 and 2019. Cases involving malalignment (> 5° of deviation from anatomic axis on either coronal/sagittal axis) on final follow-up (minimum three months postoperatively) were compared to those without malalignment with regard to demographics, fracture characteristics, intraoperative characteristics, and complications. RESULTS: The rate of malalignment was 13%. On multivariate analysis, multiplanar distal interlocking screw fixation (odds ratio [OR], 0.18; 95% confidence interval [CI] 0.03-0.92) was associated with a decreased rate of final malalignment, while nail diameter > 10 mm was associated with a higher rate (OR, 4.05; 95% CI 1.25-13.11). Fibular fixation was not associated with malalignment. CONCLUSION: Multiplanar distal interlocking screws may protect against malalignment. Fibula fixation does not appear associated with a decreased rate of malalignment in distal tibia fractures treated with intramedullary nails. LEVEL OF EVIDENCE: III.

Repaglinide Induces ATF6 Processing and Neuroprotection in Transgenic SOD1G93A Mice.

The interaction of the activating transcription factor 6 (ATF6), a key effector of the unfolded protein response (UPR) in the endoplasmic reticulum, with the neuronal calcium sensor Downstream Regulatory Element Antagonist Modulator (DREAM) is a potential therapeutic target in neurodegeneration. Modulation of the ATF6-DREAM interaction with repaglinide (RP) induced neuroprotection in a model of Huntington's disease. Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with no cure, characterized by the progressive loss of motoneurons resulting in muscle denervation, atrophy, paralysis, and death. The aim of this work was to investigate the potential therapeutic significance of DREAM as a target for intervention in ALS. We found that the expression of the DREAM protein was reduced in the spinal cord of SOD1G93A mice compared to wild-type littermates. RP treatment improved motor strength and reduced the expression of the ALS progression marker collagen type XIXα1 (Col19α1 mRNA) in the quadriceps muscle in SOD1G93A mice. Moreover, treated SOD1G93A mice showed reduced motoneuron loss and glial activation and increased ATF6 processing in the spinal cord. These results indicate that the modulation of the DREAM-ATF6 interaction ameliorates ALS symptoms in SOD1G93A mice.

Joint aspiration and serum markers - do they matter in the diagnosis of native shoulder sepsis? A systematic review.

BACKGROUND: Septic arthritis of the native shoulder is traditionally diagnosed with the same strategies as knee or hip septic arthritis. However, septic arthritis of the shoulder is frequently a missed or delayed diagnosis. Reliance on aspiration and serum markers has been called into question recently. The purpose of this study was to conduct a systematic review investigating the value of joint aspiration and serum markers in the diagnosis of native shoulder joint sepsis. METHODS: PubMed/MEDLINE, Scopus, and the Cochrane Library were used in the systematic literature search from January 1, 1960, through January 23, 2021. The primary outcome was to report on the synovial white cell count of patients with native shoulder sepsis. Descriptive statistics using percentages, means, and intraclass correlation coefficient (ICC) values were used to summarize the results. RESULTS: Thirty-one studies, including 25 case series, one case-control, and five cohort studies with a total of 7434 native shoulder joints, were included. There was no standardized approach to diagnosing septic arthritis of the shoulder. Only 10 studies (32%) reported on synovial white cell count with the majority yielding aspiration counts greater than 50,000 cells/mm3, although one study was as low as 30,000 cells/mm3. CONCLUSIONS: The diagnosis of native shoulder joint sepsis lacks uniformity. Methods used to evaluate shoulder sepsis are heterogeneous and may lead to delays or misdiagnosis with devastating sequelae. Synovial white cell count is underutilized and may also present with a lower value than expected, which is likely related to the time interval between symptom onset and diagnosis.

IQM-PC332, a Novel DREAM Ligand with Antinociceptive Effect on Peripheral Nerve Injury-Induced Pain.

Neuropathic pain is a form of chronic pain arising from damage of the neural cells that sense, transmit or process sensory information. Given its growing prevalence and common refractoriness to conventional analgesics, the development of new drugs with pain relief effects constitutes a prominent clinical need. In this respect, drugs that reduce activity of sensory neurons by modulating ion channels hold the promise to become effective analgesics. Here, we evaluated the mechanical antinociceptive effect of IQM-PC332, a novel ligand of the multifunctional protein downstream regulatory element antagonist modulator (DREAM) in rats subjected to chronic constriction injury of the sciatic nerve as a model of neuropathic pain. IQM-PC332 administered by intraplantar (0.01-10 µg) or intraperitoneal (0.02-1 µg/kg) injection reduced mechanical sensitivity by ≈100% of the maximum possible effect, with ED50 of 0.27 ± 0.05 µg and 0.09 ± 0.01 µg/kg, respectively. Perforated-patch whole-cell recordings in isolated dorsal root ganglion (DRG) neurons showed that IQM-PC332 (1 and 10 µM) reduced ionic currents through voltage-gated K+ channels responsible for A-type potassium currents, low, T-type, and high voltage-activated Ca2+ channels, and transient receptor potential vanilloid-1 (TRPV1) channels. Furthermore, IQM-PC332 (1 µM) reduced electrically evoked action potentials in DRG neurons from neuropathic animals. It is suggested that by modulating multiple DREAM-ion channel signaling complexes, IQM-PC332 may serve a lead compound of novel multimodal analgesics.

Paradigms about the COVID-19 pandemic: knowledge, attitudes and practices from medical students.

BACKGROUND: As the disease caused by the novel coronavirus has spread globally, there has been significant economic instability in the healthcare systems. This reality was especially accentuated in Ecuador where, the shortage of healthcare workers combined with cultural and macroeconomic factors has led Ecuador to face the most aggressive outbreak in Latin America. In this context, the participation of final-year medical students on the front line is indispensable. Appropriate training on COVID-19 is an urgent requirement that universities and health systems must guarantee. We aimed to describe the knowledge, attitudes, and practices of Ecuadorian final-year medical students that could potentially guide the design of better medical education curricula regarding COVID-19. METHODS: This was a cross-sectional 33-item online survey conducted between April 6 to April 2020 assessing the knowledge, attitudes, and practices toward the diagnosis, treatment, prevention, and prognosis toward COVID-19 in Ecuadorian final-year medical students. It was sent by email, Facebook, and WhatsApp. RESULTS: A total of 309 students responded to the survey. Out of which 88% of students scored high (≥ 70% correct) for knowledge of the disease. The majority of students were pessimistic about possible government actions, which is reflected in the negative attitude towards the control of COVID-19 and volunteering during the outbreak in Ecuador (77%, and 58% of the students, respectively). Moreover, 91% of students said they did not have adequate protective equipment. The latter finding was significantly associated with negative attitudes. CONCLUSIONS: Although a large number of students displayed negative attitudes, the non-depreciable percentage of students who were willing to volunteer and the coexisting high level of knowledge displayed by students, suggests that Ecuador has a capable upcoming workforce that could benefit from an opportunity to strengthen, improve and advance their training in preparation for COVID-19. Not having personal protective equipment was significantly associated to negative attitudes. Providing the necessary tools and creating a national curriculum may be one of the most effective ways to ensure all students are trained, whilst simultaneously focusing on the students' most pressing concerns. With this additional training, negative attitudes will improve and students will be better qualified.

Design of an Automated Multiposition Dynamic Wheelchair.

This work presents a design for an automatized multiposition dynamic wheelchair used to transport quadriplegic patients by reconfiguring a manual wheelchair structure. An electric actuator is attached to a four-bar mechanism fixed to each side of a wheelchair's backrest to reach multiposition. The entire device is actuated through a PID controller. An experimental test is carried out in a simplified wheelchair structure. Finally, the structure of the wheelchair is evaluated through the Dynamic analysis and Finite Element Method under the payload computed with the most critical position reached by the mechanism.

Outpatient surgery in patients with ankle fractures minimises hospital admissions and utilisation of healthcare resources.

PURPOSE: The recent outbreak of the novel coronavirus (SARS-CoV-2) has emphasised the need to minimise hospital admissions and utilisation of healthcare resources. The purpose of this study was to examine the outcomes of an outpatient surgery protocol for acute closed ankle fractures. METHODS: In this retrospective study, 262 patients underwent outpatient surgery for their closed ankle fractures at our level-1 trauma centre. A total of 196 patients met our inclusion criteria and were ultimately included in the final analysis. Our primary outcomes' measures included post-operative admission to the emergency department within 30 days after surgery and unplanned hospital readmission within 30 days after surgery. Our secondary outcome measure included the incidence of surgical site infection (SSI) within 12 weeks after surgery. RESULTS: Thirty-two patients (16.3%) had an unplanned emergency department visit within 30 days of fracture fixation and two patients (1.0%) required hospital readmission within 30 days of their surgery. Sixteen patients (8.2%) developed SSI, which included 11 (5.6%) superficial and five (2.6%) deep infections. CONCLUSION: Strategic outpatient management of acute closed ankle fractures is associated with acceptable rates of unplanned emergency department visits, hospital readmissions, and SSIs. In the context of the recent SARS-CoV-2 outbreak, outpatient management of these injuries may aide in the mitigation of nosocomial infections and the preservation of finite healthcare resources.

Non-contact wide-angled visualization with chandelier-assisted scleral buckling for primary uncomplicated rhegmatogenous retinal detachment.

PURPOSE: To report our experience in non-contact wide-angled visualization with chandelier-assisted scleral buckling (SB) in uncomplicated primary rhegmatogenous retinal detachments (RRD). METHODS: Retrospective case series of 282 eyes that underwent non-contact wide-angled visualization with chandelier-assisted SB and were followed for a mean of 13.5 months. RESULTS: There were 160 male patients. The average age was 42.6 years old. There were 262 eyes that were phakic, 18 pseudophakic, and 2 aphakic. Two-thirds of eyes presented with the macula detached. Eyes had an average of 1.6 breaks. The single operation anatomic success rate was 85.1% (240/282). The pre-op visual acuity improved from 1.21 to 0.76 logMAR at 6 months (p < 0.0001). Complications included a case of scleral laceration, choroidal hemorrhage, 3 epiretinal membranes, 1 macular fold, and 4 eyes with buckle exposure. CONCLUSION: Non-contact wide-angled visualization with chandelier-assisted SB compares favorably with conventional SB for primary uncomplicated primary RRD.

A Systematic Methodology to Evaluate Prediction Models for Driving Style Classification.

Identifying driving styles using classification models with in-vehicle data can provide automated feedback to drivers on their driving behavior, particularly if they are driving safely. Although several classification models have been developed for this purpose, there is no consensus on which classifier performs better at identifying driving styles. Therefore, more research is needed to evaluate classification models by comparing performance metrics. In this paper, a data-driven machine-learning methodology for classifying driving styles is introduced. This methodology is grounded in well-established machine-learning (ML) methods and literature related to driving-styles research. The methodology is illustrated through a study involving data collected from 50 drivers from two different cities in a naturalistic setting. Five features were extracted from the raw data. Fifteen experts were involved in the data labeling to derive the ground truth of the dataset. The dataset fed five different models (Support Vector Machines (SVM), Artificial Neural Networks (ANN), fuzzy logic, k-Nearest Neighbor (kNN), and Random Forests (RF)). These models were evaluated in terms of a set of performance metrics and statistical tests. The experimental results from performance metrics showed that SVM outperformed the other four models, achieving an average accuracy of 0.96, F1-Score of 0.9595, Area Under the Curve (AUC) of 0.9730, and Kappa of 0.9375. In addition, Wilcoxon tests indicated that ANN predicts differently to the other four models. These promising results demonstrate that the proposed methodology may support researchers in making informed decisions about which ML model performs better for driving-styles classification.

Transcriptional repressor DREAM regulates trigeminal noxious perception.

Expression of the downstream regulatory element antagonist modulator (DREAM) protein in dorsal root ganglia and spinal cord is related to endogenous control mechanisms of acute and chronic pain. In primary sensory trigeminal neurons, high levels of endogenous DREAM protein are preferentially localized in the nucleus, suggesting a major transcriptional role. Here, we show that transgenic mice expressing a dominant active mutant of DREAM in trigeminal neurons show increased responses following orofacial sensory stimulation, which correlates with a decreased expression of prodynorphin and brain-derived neurotrophic factor in trigeminal ganglia. Genome-wide analysis of trigeminal neurons in daDREAM transgenic mice identified cathepsin L and the monoglyceride lipase as two new DREAM transcriptional targets related to pain. Our results suggest a role for DREAM in the regulation of trigeminal nociception. This article is part of the special article series "Pain".

Kcnip1 a Ca²âº-dependent transcriptional repressor regulates the size of the neural plate in Xenopus.

In amphibian embryos, our previous work has demonstrated that calcium transients occurring in the dorsal ectoderm at the onset of gastrulation are necessary and sufficient to engage the ectodermal cells into a neural fate by inducing neural specific genes. Some of these genes are direct targets of calcium. Here we search for a direct transcriptional mechanism by which calcium signals are acting. The only known mechanism responsible for a direct action of calcium on gene transcription involves an EF-hand Ca²âº binding protein which belongs to a group of four proteins (Kcnip1 to 4). Kcnip protein can act in a Ca²âº-dependent manner as a transcriptional repressor by binding to a specific DNA sequence, the Downstream Regulatory Element (DRE) site. In Xenopus, among the four kcnips, we show that only kcnip1 is timely and spatially present in the presumptive neural territories and is able to bind DRE sites in a Ca²âº-dependent manner. The loss of function of kcnip1 results in the expansion of the neural plate through an increased proliferation of neural progenitors. Later on, this leads to an impairment in the development of anterior neural structures. We propose that, in the embryo, at the onset of neurogenesis Kcnip1 is the Ca²âº-dependent transcriptional repressor that controls the size of the neural plate. This article is part of a Special Issue entitled: 13th European Symposium on Calcium.

Definition of an Enhanced Map-Matching Algorithm for Urban Environments with Poor GNSS Signal Quality.

Vehicle positioning is a key factor for numerous information and assistance applications that are included in vehicles and for which satellite positioning is mainly used. However, this positioning process can result in errors and lead to measurement uncertainties. These errors come mainly from two sources: errors and simplifications of digital maps and errors in locating the vehicle. From that inaccurate data, the task of assigning the vehicle's location to a link on the digital map at every instant is carried out by map-matching algorithms. These algorithms have been developed to fulfil that need and attempt to amend these errors to offer the user a suitable positioning. In this research; an algorithm is developed that attempts to solve the errors in positioning when the Global Navigation Satellite System (GNSS) signal reception is frequently lost. The algorithm has been tested with satisfactory results in a complex urban environment of narrow streets and tall buildings where errors and signal reception losses of the GPS receiver are frequent.

Analysis of Uncertainty in a Middle-Cost Device for 3D Measurements in BIM Perspective.

Medium-cost devices equipped with sensors are being developed to get 3D measurements. Some allow for generating geometric models and point clouds. Nevertheless, the accuracy of these measurements should be evaluated, taking into account the requirements of the Building Information Model (BIM). This paper analyzes the uncertainty in outdoor/indoor three-dimensional coordinate measures and point clouds (using Spherical Accuracy Standard (SAS) methods) for Eyes Map, a medium-cost tablet manufactured by e-Capture Research & Development Company, Mérida, Spain. To achieve it, in outdoor tests, by means of this device, the coordinates of targets were measured from 1 to 6 m and cloud points were obtained. Subsequently, these were compared to the coordinates of the same targets measured by a Total Station. The Euclidean average distance error was 0.005-0.027 m for measurements by Photogrammetry and 0.013-0.021 m for the point clouds. All of them satisfy the tolerance for point cloud acquisition (0.051 m) according to the BIM Guide for 3D Imaging (General Services Administration); similar results are obtained in the indoor tests, with values of 0.022 m. In this paper, we establish the optimal distances for the observations in both, Photogrammetry and 3D Photomodeling modes (outdoor) and point out some working conditions to avoid in indoor environments. Finally, the authors discuss some recommendations for improving the performance and working methods of the device.

Intravehicular, Short- and Long-Range Communication Information Fusion for Providing Safe Speed Warnings.

Inappropriate speed is a relevant concurrent factor in many traffic accidents. Moreover, in recent years, traffic accidents numbers in Spain have fallen sharply, but this reduction has not been so significant on single carriageway roads. These infrastructures have less equipment than high-capacity roads, therefore measures to reduce accidents on them should be implemented in vehicles. This article describes the development and analysis of the impact on the driver of a warning system for the safe speed on each road section in terms of geometry, the presence of traffic jams, weather conditions, type of vehicle and actual driving conditions. This system is based on an application for smartphones and includes knowledge of the vehicle position via Ground Positioning System (GPS), access to intravehicular information from onboard sensors through the Controller Area Network (CAN) bus, vehicle data entry by the driver, access to roadside information (short-range communications) and access to a centralized server with information about the road in the current and following sections of the route (long-range communications). Using this information, the system calculates the safe speed, recommends the appropriate speed in advance in the following sections and provides warnings to the driver. Finally, data are sent from vehicles to a server to generate new information to disseminate to other users or to supervise drivers' behaviour. Tests in a driving simulator have been used to define the system warnings and Human Machine Interface (HMI) and final tests have been performed on real roads in order to analyze the effect of the system on driver behavior.

Vitreous humor thermodynamics during phacoemulsification.

The purpose of this study is to determine baseline vitreous humor temperature during a combined phacoemulsification and pars plana vitrectomy (PPV) procedure; to determine what is the temperature variation during phacoemulsification; and to compare vitreous temperature to sublingual temperature. The methods used are prospective, interventional and comparative study. Patients with a diagnosis of cataract and vitreous hemorrhage, programed for a combined procedure of phacoemulsification and PPV, were included. Patients were excluded if posterior capsular rupture existed during the anterior segment procedure. A thermoprobe was inserted through a PPV trocar. Measurement of the vitreous temperature was obtained at baseline and throughout phacoemulsification, at the end of every surgical step, and every 5 min. Sublingual temperature was measured with the same probe at the end of the surgery. Room temperature was registered. Seventeen eyes of 17 patients were included. Mean sublingual temperature was 36.5 °C (standard deviation [σ] 0.26 °C). Mean total vitreous temperature was 31.47 °C (σ 2.1 °C). Mean baseline vitreous temperature was 33.04 °C (σ 0.99 °C). Comparison of sublingual temperature with baseline vitreous temperature resulted in a significant difference (t test P < 0.000. 95 % confidence interval 2.93-3.98). Temperature measured by surgical step and surgical time presented a significant decrease in temperature from baseline (Kruskal-Wallis P < 0.000, P = 0.003, respectively). Vitreous humor is significantly hypothermic when compared to sublingual temperature. Vitreous temperature decreases significantly during phacoemulsification.

Vehicle tracking for an evasive manoeuvres assistant using low-cost ultrasonic sensors.

Many driver assistance systems require knowledge of the vehicle environment. As these systems are increasing in complexity and performance, this knowledge of the environment needs to be more complete and reliable, so sensor fusion combining long, medium and short range sensors is now being used. This paper analyzes the feasibility of using ultrasonic sensors for low cost vehicle-positioning and tracking in the lane adjacent to the host vehicle in order to identify free areas around the vehicle and provide information to an automatic avoidance collision system that can perform autonomous braking and lane change manoeuvres. A laser scanner is used for the early detection of obstacles in the direction of travel while two ultrasonic sensors monitor the blind spot of the host vehicle. The results of tests on a test track demonstrate the ability of these sensors to accurately determine the kinematic variables of the obstacles encountered, despite a clear limitation in range.

Bidirectional ventricular tachycardia due to digoxin-diuretic interaction in post-cardiac surgery patient: a case report.

Bidirectional ventricular tachycardia (BVT) is a rare form of malignant ventricular arrhythmia characterized by beat-to-beat alternation in the QRS axis. BVT is a hallmark of digitalis toxicity, but digoxin-induced BVT secondary to digoxin-diuretic interaction in cardiac surgery patients is not widely reported. We present the case of a 62-year-old woman undergoing mitral valve replacement with tricuspid annuloplasty who developed postoperative congestive heart failure and vasoplegic syndrome requiring norepinephrine, vasopressin, and loop diuretics. During postoperative care, she presented atrial fibrillation with rapid ventricular response, achieving rate control with digoxin, but later displayed hemodynamically stable BVT associated with digitalis toxicity. The case highlights the importance of physicians monitoring digoxin toxicity when prescribing digoxin to patients with a diuretic regimen, particularly loop diuretics. During digoxin-induced-BVT, supportive treatment, including discontinuing digitalis coupled with potassium and magnesium supplements, can be considered as long as digoxin-specific antibodies are unavailable, and the patient is hemodynamically stable.

La taquicardia ventricular bidireccional (TVB) es una arritmia rara caracterizada por alternancia latido a latido en el eje QRS. La TVB es característica de intoxicación digitálica; sin embargo, la TVB secundaria a interacción digoxina-diurético en pacientes posoperados de cirugía cardíaca no se ha reportado ampliamente. Presentamos el caso de una mujer de 62 años sometida a cirugía cardiaca que desarrolló falla cardiaca congestiva y síndrome vasopléjico en el posoperatorio por lo que requirió noradrenalina, vasopresina y diurético de asa. Durante la hospitalización presentó fibrilación auricular con respuesta ventricular rápida; se logró control con digoxina, pero posteriormente presentó TVB asociada a intoxicación digitálica. Este caso resalta la importancia de detectar intoxicación digitálica durante la prescripción de digoxina a pacientes con un régimen diurético, especialmente diuréticos de asa. Durante la TVB inducida por digoxina, el tratamiento de soporte se puede considerar cuando no haya disponible anticuerpos específicos para digoxina y el paciente este hemodinámicamente estable.

Preliminary clinical and radiological evaluation of osteosynthesis using the Femoral Neck System (FNS) for subcapital fractures of the femur.

Addressing subcapital fractures of the femur poses a substantial clinical challenge, complicated by the diverse range of available osteosynthesis materials. This study is dedicated to a comprehensive analysis of the clinical and radiological implications linked with the implementation of the Femoral Neck System (FNS) in osteosynthesis procedures. A descriptive study was conducted involving patients who underwent osteosynthesis for subcapital fractures of the femur utilizing the FNS during the period from 2019 to 2022. The investigation encompassed various facets, including the classification of fractures according to the Garden and Pauwells classifications, criteria for achieving precise reduction based on the Garden criteria and Tip Apex Distance (TAD). At the one-year follow-up, factors such as fracture consolidation, loss of reduction, fracture collapse, complications, and functional outcomes were evaluated utilizing the Harris Hip Score (HHS) scale. The study cohort included a total of 26 patients, among whom 22 exhibited non-displaced subcapital femur fractures categorized as Garden I and II. Successful reduction was accomplished in 23 cases, in which 24 cases (92.3%) displayed a TAD measurement below 25 mm. According to the HHS, patients achieved an average score of 90.9 (ranging from 63 to 100) following the surgical intervention, with predominantly "excellent" and "good" outcomes. The outcomes derived from our investigation corroborate the viability of the Femoral Neck System (FNS) as a reliable option for osteosynthesis in femoral neck fractures. The results obtained are comparable to those achieved with other available implants, as highlighted by previous studies.