Effectiveness of percutaneous compression plate fixation for femoral neck fractures_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

XU Kelin ¹ , LIU Yu ² ^△ , WANG Jianwei ¹ , YAN Songhe ¹ , LIU Xiaofeng ¹ ,  LI Haifeng ² , GU Sanjun ²

1. Department of Orthopedics and Traumatology, Wuxi Traditional Chinese Medicine Hospital, Wuxi Jiangsu, 214000, P.R.China;
2. Department of Orthopedics, the 9th People’s Hospital of Wuxi (Wuxi Orthopedic Hospital), Wuxi Jiangsu, 214062, P.R.China;

Corresponding?author：

LI Haifeng, Email: wxsyqd@163.com

Keywords：

Femoral neck fracture; percutaneous compression plate; sliding compression; internal fixation; bone healing

DOI：

10.7507/1002-1892.202002050

Video：

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Objective To investigate the effectiveness of percutaneous compression plate (PCCP) fixation for femoral neck fracture.Methods A clinical data of 100 patients with femoral neck fractures who were treated with internal fixation were analyzed retrospectively. The fractures were fixed with the cannulated screws (CS) in 55 patients (CS group) and with the PCCP in 45 patients (PCCP group). There was no significant difference in gender, age, the cause of injury, the fracture type, complications, and disease duration between the two groups (P>0.05). The quality of fracture reduction, bone resorption, screw slipping, femoral neck shortening, complications (nonunion, failure of fixation, and osteonecrosis of femoral head), and functional recovery of hip (Harris score) were compared between the two groups.Results All incisions healed by first intention. All patients were followed up 24-56 months, with an average of 30.7 months. The quality of fracture reduction was excellent in 26 cases, good in 18 cases, fair in 9 cases, and poor in 2 cases in CS group and excellent in 21 cases, good in 17 cases, fair in 4 cases, and poor in 3 cases in PCCP group, showing no significant difference between the two groups (Z=?0.283, P=0.773). The incidence of nonunion in PCCP group was significantly lower than that in CS group (P=0.046), and the fracture healing time in PCCP group was shorter than that in CS group (t=2.155, P=0.034). There was no significant difference in the incidences of bone resorption, screw slipping, femoral neck shortening, failure of fixation, and osteonecrosis of femoral head between the two groups (P>0.05). The overall complication rates were 27.27% (15/55) in CS group and 8.89% (4/45) in PCCP group, showing significant difference (χ²=5.435, P=0.020). The Harris score in PCCP group at 6 months after operation was significantly higher than that in CS group (t=?2.073, P=0.041). However, there was no significant difference in the Harris score at 12, 18, and 24 months after operation between the two groups (P>0.05).Conclusion Stable sliding compression of PCCP is benefit for the femoral neck fracture healing, especially shortening union.

Citation： XU Kelin, LIU Yu, WANG Jianwei, YAN Songhe, LIU Xiaofeng, LI Haifeng, GU Sanjun. Effectiveness of percutaneous compression plate fixation for femoral neck fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(11): 1364-1368. doi: 10.7507/1002-1892.202002050 Copy

1.	陳大為, 夏紅. 三枚空心釘治療股骨頸骨折研究進展. 中國醫師雜志, 2019, 21(1): 158-160.
2.	袁凱旋, 羅鵬波, 張長青. 全螺紋空心螺釘治療股骨頸骨折研究進展. 國際骨科學雜志, 2019, 40(3): 140-142.
3.	Wang G, Tang Y, Wang B, et al. Minimally invasive open reduction combined with proximal femoral hollow locking plate in the treatment of Pauwels type Ⅲ femoral neck fracture. J Int Med Res, 2019, 47(7): 3050-3060.
4.	Shu DP, Xiao YP, Bei MJ, et al. Dynamic compression locking system versus multiple cannulated compression screw for the treatment of femoral neck fractures: a comparative study. BMC Musculoskelet Disord, 2020, 21(1): 230.
5.	Brandt E, Verdonschot N, Vugt AV, et al. Biomechanical analysis of the percutaneous compression plate and sliding hip screw in incapsular hip fractures: experimental assessment using synthetic and cadaver bones. Injury, 2006, 37(10): 979-983.
6.	Brandt SE. A new and stable implant in the treatment of intracapsular hip fracture: a case report. Injury Extra, 2008, 39(4): 137-139.
7.	Mukherjee P, Ashworth MJ. A new device to treat intra-capsular fracture neck of femur nonunion. Strategies Trauma Limb Reconstr, 2010, 5(3): 159-162.
8.	Zhu F, Liu G, Shao HG, et al. Treatment of femoral neck fracture with percutaneous compression plate: preliminary results in 74 patients. Orthop Surg, 2015, 7(2): 132-137.
9.	朱鋒, 徐耀增, 耿德春, 等. 經皮加壓鋼板與空心加壓螺釘治療中青年移位型股骨頸骨折的療效比較. 中華創傷骨科雜志, 2014, 30(8): 731-733.
10.	葉俊星, 戴漣生, 王松華, 等. 經皮加壓鋼板與空心釘治療股骨頸骨折的臨床療效比較. 中國現代醫學雜志, 2017, 27(19): 45-48.
11.	林明, 車群江, 梁海波. 經皮加壓鋼板與空心加壓螺釘治療中青年移位型股骨頸骨折的療效對比觀察. 中國醫學創新, 2015, 12(18): 61-64.
12.	中華醫學會骨科分會顯微修復學組, 中國修復重建外科專業委員會骨缺損及骨壞死學組. 成人股骨頭壞死診療標準專家共識 (2012 年版). 中華關節外科雜志 (電子版), 2012, 6(3): 479-484.
13.	張世民, 李海豐, 黃軼剛. 骨折分類與功能評定. 北京: 人民軍醫出版社, 2008: 321-322.
14.	Zielinski SM, Keijsers NL, Praet SF, et al. Femoral neck shortening after internal fixation of a femoral neck fracture. Orthopedics, 2013, 36(7): e849-e858.
15.	李偉龍, 余霄, 龐清江. 股骨頸骨折內固定術后股骨頸短縮的相關研究進展. 中華骨科雜志, 2016, 36(6): 378-384.
16.	劉振東, 秦泗河. 骨折斷端磨損性骨吸收的證據分析. 中國矯形外科雜志, 2015, 23(12): 1147-1152.
17.	Haider T, Schnabel J, Hochp?chler J, et al. Femoral shortening does not impair functional outcome after internal fixation of femoral neck fractures in non-geriatric patients. Arch Orthop Trauma Surg, 2018, 138(11): 1511-1517.
18.	Dong Q, Han Z, Zhang YG, et al. Comparison of transverse cancellous lag screw and ordinary cannulated screw fixations in treatment of vertical femoral neck fractures. Orthop Surg, 2019, 11(4): 595-603.

1. 陳大為, 夏紅. 三枚空心釘治療股骨頸骨折研究進展. 中國醫師雜志, 2019, 21(1): 158-160.
2. 袁凱旋, 羅鵬波, 張長青. 全螺紋空心螺釘治療股骨頸骨折研究進展. 國際骨科學雜志, 2019, 40(3): 140-142.
3. Wang G, Tang Y, Wang B, et al. Minimally invasive open reduction combined with proximal femoral hollow locking plate in the treatment of Pauwels type Ⅲ femoral neck fracture. J Int Med Res, 2019, 47(7): 3050-3060.
4. Shu DP, Xiao YP, Bei MJ, et al. Dynamic compression locking system versus multiple cannulated compression screw for the treatment of femoral neck fractures: a comparative study. BMC Musculoskelet Disord, 2020, 21(1): 230.
5. Brandt E, Verdonschot N, Vugt AV, et al. Biomechanical analysis of the percutaneous compression plate and sliding hip screw in incapsular hip fractures: experimental assessment using synthetic and cadaver bones. Injury, 2006, 37(10): 979-983.
6. Brandt SE. A new and stable implant in the treatment of intracapsular hip fracture: a case report. Injury Extra, 2008, 39(4): 137-139.
7. Mukherjee P, Ashworth MJ. A new device to treat intra-capsular fracture neck of femur nonunion. Strategies Trauma Limb Reconstr, 2010, 5(3): 159-162.
8. Zhu F, Liu G, Shao HG, et al. Treatment of femoral neck fracture with percutaneous compression plate: preliminary results in 74 patients. Orthop Surg, 2015, 7(2): 132-137.
9. 朱鋒, 徐耀增, 耿德春, 等. 經皮加壓鋼板與空心加壓螺釘治療中青年移位型股骨頸骨折的療效比較. 中華創傷骨科雜志, 2014, 30(8): 731-733.
10. 葉俊星, 戴漣生, 王松華, 等. 經皮加壓鋼板與空心釘治療股骨頸骨折的臨床療效比較. 中國現代醫學雜志, 2017, 27(19): 45-48.
11. 林明, 車群江, 梁海波. 經皮加壓鋼板與空心加壓螺釘治療中青年移位型股骨頸骨折的療效對比觀察. 中國醫學創新, 2015, 12(18): 61-64.
12. 中華醫學會骨科分會顯微修復學組, 中國修復重建外科專業委員會骨缺損及骨壞死學組. 成人股骨頭壞死診療標準專家共識 (2012 年版). 中華關節外科雜志 (電子版), 2012, 6(3): 479-484.
13. 張世民, 李海豐, 黃軼剛. 骨折分類與功能評定. 北京: 人民軍醫出版社, 2008: 321-322.
14. Zielinski SM, Keijsers NL, Praet SF, et al. Femoral neck shortening after internal fixation of a femoral neck fracture. Orthopedics, 2013, 36(7): e849-e858.
15. 李偉龍, 余霄, 龐清江. 股骨頸骨折內固定術后股骨頸短縮的相關研究進展. 中華骨科雜志, 2016, 36(6): 378-384.
16. 劉振東, 秦泗河. 骨折斷端磨損性骨吸收的證據分析. 中國矯形外科雜志, 2015, 23(12): 1147-1152.
17. Haider T, Schnabel J, Hochp?chler J, et al. Femoral shortening does not impair functional outcome after internal fixation of femoral neck fractures in non-geriatric patients. Arch Orthop Trauma Surg, 2018, 138(11): 1511-1517.
18. Dong Q, Han Z, Zhang YG, et al. Comparison of transverse cancellous lag screw and ordinary cannulated screw fixations in treatment of vertical femoral neck fractures. Orthop Surg, 2019, 11(4): 595-603.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of percutaneous compression plate fixation for femoral neck fractures

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