Pauwels type III femoral neck fracture treated with three and four cannulated screws assisted by robot navigation

doi:10.12307/2022.589

Abstract

Abstract: BACKGROUND: At present, three cannulated screws cannot provide enough stability for Pauwels type III femoral neck fracture. Four cannulated screws can provide better stability than three cannulated screws, but the space of the femoral neck is narrow and the screw drilling is extremely easy to fail. Robot navigation technology can effectively solve this problem.
OBJECTIVE: To compare the clinical efficacy of three and four cannulated screws under robot navigation for Pauwels type III femoral neck fractures.
METHODS: The clinical data of 72 cases of Pauwels type III femoral neck fracture treated with cannulated screws fixation assisted by robot navigation in Zigong Fourth People’s Hospital from July 2013 to May 2020 were collected, including 37 males and 45 females, at the age of 16-66 years old. Forty-two cases were fixed with three screws and thirty cases with four screws. The operation time, number of needle insertions, number of intraoperative fluoroscopy, blood loss, incision length, wound healing, fracture healing rate, fracture reduction, femoral head necrosis, hip Harris Score, and full weight-bearing time were recorded in both groups.
RESULTS AND CONCLUSION: All 72 patients were followed up after operation. All incisions were healed by first intention. There were no incision infection cases, and the fracture healing rate was 100%. Femoral head necrosis occurred in three cases in the three-screw group. There was no femoral head necrosis in the four-screw group. No adverse reactions caused by cannulated screws occurred during the follow-up. There was no significant difference between the two groups in the number of needle placements, blood loss, and fracture reduction (P > 0.05). Compared with the three-screw group, the four-screw group had longer operation time, more intraoperative fluoroscopy, and longer incision length (P < 0.05). Compared with the three-screw group, the fracture healing time and the time of full weight-bearing were shortened in the four-screw group (P < 0.05). The Harris score of hip joint in the four-screw group was higher than that in the three-screw group at 6 months after surgery (P < 0.05). Results have indicated that compared with three cannulated screws by the assistance of robot navigation, the four cannulated screws for the treatment of Pauwels type III femoral neck fractures have shorter fracture healing time, shorter time of full weight-bearing, and better hip joint function.

Key words: robot navigation, femoral neck fracture, fracture reduction, fracture healing, cannulated screw, internal fixation

CLC Number:

Wang Jiaqi, Luo Xiaozhong, Tong Yi, Shi Weixiang, Ding Yong, Zhou Xin, Wu Gang. Pauwels type III femoral neck fracture treated with three and four cannulated screws assisted by robot navigation[J]. Chinese Journal of Tissue Engineering Research, 2022, 26(15): 2352-2355.

Figures/Tables 5

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