Surgical treatment of Pauwels type-3 femoral neck fractures:46 analysis
GAO You-shui
CHEN Song
ZHOU Zu-bin
YU Xiao-wei
SONG Wen-qi
ZHANG Wei
SUN Yu-qiang
ZHANG Chang-qing
Abstract：Objective To retrospectively analyze the surgical treatment outcomes of Pauwels type-3 femoral neck fractures. Methods From January 2011 to November 2011, 46 patients with Pauwels type-3 femoral neck fractures were surgically treated. Cannulated screws ( CS ) were used in 35 patients, dynamic hip screws plus CS ( DHS+CS ) in 8 patients and proximal femoral locking compression plates ( LCP ) in 3 patients. Reduction quality was assessed according to Haidukewych criteria. Regular radiographic examinations were employed postoperatively to observe fracture healing and general condition of the hip joint. The association between fracture displacement, comminution and method of internal ifxation and the incidence of femoral neck nonunion and osteonecrosis of the femoral head ( ONFH ) were analyzed. Results Thirty-one of the 46 patients had intact follow-up data. Postoperative deep infections were noticed in 1 patient who was treated by DHS+CS. And then the patient underwent debridement and anti-infective treatment. Hardware removal was performed following malunion at 6 months after the operation. The other 30 patients were followed up for ( 20.1±5.9 ) months. Fractures were stabilized by CS in 22 patients, by DHS+CS in 5 patients and by LCP in 3 patients. In terms of reduction quality, 29 patients were graded as excellent, and while 1 patient was fair. ONFH was noticed in 8 patients and nonunion in 2 patients. One patient had ONFH and nonunion concomitantly. Good hip contour was preserved in 19 patients ( 63.3%). There were no statistically signiifcant differences regarding fracture displacement, comminution and method of internal ifxation and the incidence of ONFH and nonunion. Conclusions ONFH and nonunion are common postoperative complications in the treatment of Pauwels type-3 femoral neck fractures. CS, DHS+CS and LCP can be employed in the stabilization of Pauwels type-3 femoral neck fractures. However, the effects of fracture displacement, comminution and method of internal ifxation on ONFH and nonunion are undeifned, and a larger number of patients are desired for future study.
Keywords：Femur neckFemoral fracturesSurgical proceduresoperativeTreatment outcomeFracturesbone
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 96-100 )