Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (18): 2869-2874.doi: 10.3969/j.issn.2095-4344.3830

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Cannulated screw combined with buttress plate in treatment of Pauwels III femoral neck fracture in middle-aged and young adults

Wei Feng, Zhou Yejin, Yao Tao, Shan Tao   

  1. Department of Orthopedic Trauma, The Third Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China
  • Received:2020-06-20 Revised:2020-06-30 Accepted:2020-07-29 Online:2021-06-28 Published:2021-01-18
  • Contact: Zhou Yejin, Chief physician, Department of Orthopedic Trauma, The Third Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China
  • About author:Wei Feng, Master candidate, Physician, Department of Orthopedic Trauma, The Third Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China

Abstract: BACKGROUND: For Pauwels type III femoral neck fracture, it is not clear which internal fixation method is more advantageous.
OBJECTIVE: To compare the efficacy of direct anterior approach combined with medial buttress plate and simple cannulated screw for treatment of Pauwels III type femoral neck fracture in middle-aged and young adults. 
METHODS: Totally 76 young and middle-aged and young patients with Pauwels III type femoral neck fracture in The Third Affiliated Hospital of Anhui Medical University (Hefei First People’s Hospital) from January 2015 to January 2019 were retrospectively analyzed. There were 42 males and 34 females, at the age of (44.5±6.6) years. Totally 35 patients in the observation group were treated with cannulated screws combined with medial buttress plate. In the control group, 41 cases were fixed with cannulated screws only. The fracture healing time, Harris hip score, visual analogue scale score, and the incidence of complications were observed during follow-up. The trial was approved by the Ethics Committee of The Third Affiliated Hospital of Anhui Medical University (approval No. LYPD2018(20)). 
RESULTS AND CONCLUSION: (1) The postoperative follow-up time of the two groups ranged from 16 to 18 months (averagely 17.24 months). The fracture healing time of the observation group was shorter than that of the control group (P < 0.05). (2) In the observation group, among 32 cases, there were 1 case of incision infection and 1 case of internal fixation failure, and the incidence of complications was 9%. In the control group, among 42 cases, there were 2 cases of fracture nonunion, 2 cases of delayed union of fracture, 5 cases of internal fixation failure and 4 cases of femoral head necrosis, and the incidence of complications was 32%. The difference in the incidence of complications between the two groups was significant (P < 0.05). (3) The excellent and good rate of Harris hip score in the observation group was higher than that in the control group (82%, 73%, P < 0.05). (4) The visual analogue scale score of the observation group was lower than that of the control group at 3 and 6 months after operation (P < 0.05). (5) Results suggest that clinical effect of direct anterior approach cannulated screw combined with medial buttress plate fixation in the treatment of Pauwels III femoral neck fracture in young and middle-aged adults is better than that of simple cannulated screw fixation, which can promote fracture healing and recovery of hip function, and reduce the occurrence of complications.  

Key words: bone, material, internal fixation, implant, femoral neck, fracture, cannulated screw, medial buttress plate, internal fixation

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