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.	陈大为, 夏红. 三枚空心钉治疗股骨颈骨折研究进展. 中国医师杂志, 2019, 21(1): 158-160.
2.	袁凯旋, 罗鹏波, 张长青. 全螺纹空心螺钉治疗股骨颈骨折研究进展. 国际骨科学杂志, 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.	朱锋, 徐耀增, 耿德春, 等. 经皮加压钢板与空心加压螺钉治疗中青年移位型股骨颈骨折的疗效比较. 中华创伤骨科杂志, 2014, 30(8): 731-733.
10.	叶俊星, 戴涟生, 王松华, 等. 经皮加压钢板与空心钉治疗股骨颈骨折的临床疗效比较. 中国现代医学杂志, 2017, 27(19): 45-48.
11.	林明, 车群江, 梁海波. 经皮加压钢板与空心加压螺钉治疗中青年移位型股骨颈骨折的疗效对比观察. 中国医学创新, 2015, 12(18): 61-64.
12.	中华医学会骨科分会显微修复学组, 中国修复重建外科专业委员会骨缺损及骨坏死学组. 成人股骨头坏死诊疗标准专家共识 (2012 年版). 中华关节外科杂志 (电子版), 2012, 6(3): 479-484.
13.	张世民, 李海丰, 黄轶刚. 骨折分类与功能评定. 北京: 人民军医出版社, 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.	李伟龙, 余霄, 庞清江. 股骨颈骨折内固定术后股骨颈短缩的相关研究进展. 中华骨科杂志, 2016, 36(6): 378-384.
16.	刘振东, 秦泗河. 骨折断端磨损性骨吸收的证据分析. 中国矫形外科杂志, 2015, 23(12): 1147-1152.
17.	Haider T, Schnabel J, Hochpöchler 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. 陈大为, 夏红. 三枚空心钉治疗股骨颈骨折研究进展. 中国医师杂志, 2019, 21(1): 158-160.
2. 袁凯旋, 罗鹏波, 张长青. 全螺纹空心螺钉治疗股骨颈骨折研究进展. 国际骨科学杂志, 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. 朱锋, 徐耀增, 耿德春, 等. 经皮加压钢板与空心加压螺钉治疗中青年移位型股骨颈骨折的疗效比较. 中华创伤骨科杂志, 2014, 30(8): 731-733.
10. 叶俊星, 戴涟生, 王松华, 等. 经皮加压钢板与空心钉治疗股骨颈骨折的临床疗效比较. 中国现代医学杂志, 2017, 27(19): 45-48.
11. 林明, 车群江, 梁海波. 经皮加压钢板与空心加压螺钉治疗中青年移位型股骨颈骨折的疗效对比观察. 中国医学创新, 2015, 12(18): 61-64.
12. 中华医学会骨科分会显微修复学组, 中国修复重建外科专业委员会骨缺损及骨坏死学组. 成人股骨头坏死诊疗标准专家共识 (2012 年版). 中华关节外科杂志 (电子版), 2012, 6(3): 479-484.
13. 张世民, 李海丰, 黄轶刚. 骨折分类与功能评定. 北京: 人民军医出版社, 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. 李伟龙, 余霄, 庞清江. 股骨颈骨折内固定术后股骨颈短缩的相关研究进展. 中华骨科杂志, 2016, 36(6): 378-384.
16. 刘振东, 秦泗河. 骨折断端磨损性骨吸收的证据分析. 中国矫形外科杂志, 2015, 23(12): 1147-1152.
17. Haider T, Schnabel J, Hochpöchler 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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