Analysis of the Therapeutic Effects of Percutaneous Compression Plate for Femoral Neck Fractures in Young and Middle-Aged Patients: A Retrospective Multicenter and 2-Year Follow-Up Study
Changbao Wei
Department of Orthopaedics, Wuxi No. 9 People’s Hospital Affiliated to Soochow University, Wuxi 214062, Jiangsu, P. R., China.
Haifeng Li
Department of Orthopaedics, Wuxi No. 9 People’s Hospital Affiliated to Soochow University, Wuxi 214062, Jiangsu, P. R., China.
Liansheng Dai
Department of Orthopaedics, Jiangnan University Affiliated Hospital, Wuxi 214000, Jiangsu, P.R., China.
Dong Lu
Department of Orthopaedics, Jiangyin People’s Hospital, Jiangyin 214400, Jiangsu, P.R., China.
Weichun Meng
Department of Orthopaedics, Yixing People’s Hospital, Yixing 214200, Jiangsu, P.R., China.
Sanjun Gu
Department of Orthopaedics, Wuxi No. 9 People’s Hospital Affiliated to Soochow University, Wuxi 214062, Jiangsu, P. R., China.
Yu Liu *
Department of Orthopaedics, Wuxi No. 9 People’s Hospital Affiliated to Soochow University, Wuxi 214062, Jiangsu, P. R., China.
Qudong Yin *
Department of Orthopaedics, Wuxi No. 9 People’s Hospital Affiliated to Soochow University, Wuxi 214062, Jiangsu, P. R., China.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Traditional internal fixators include hollow compression screw (HCS) and sliding hip screw for femoral neck fractures have a high incidence of complications, and are not conducive to postoperative early rehabilitation and weight-loading of patients. Therefore, femoral neck fractures are referred to as ‘unresolved fractures’. However, single-center results of percutaneous compression plate (PCCP) have showed a significant improvement in efficacy. We retrospectively analyzed the therapeutic effects of PCCP for femoral neck fractures in young and middle-aged patients in a multi-center and >2-year follow-up.
Materials and Methods: Between January 2010 and December 2017, 331 patients with femoral neck fractures in young and middle-aged patients fixed with HCS and PCCP in four hospitals were studied retrospectively.
Results: There were 182 men and 149 women, with an average age of 47.69 years (age range, 20-65 years). HCS group vs. PCCP group (170 vs. 161). There was no significant difference in the baseline data between the two groups (P>0.05). All patients were followed-up for 24-60 months (mean, 36 months). The operative time and intraoperative bleeding were significantly decreased, whereas the hospital stay significantly longer in HCS group than those in PCCP group (P<0.05). Nonunion in 17 cases and fixation failure in 14 cases in HCS group, whereas 3 and 0 cases, respectively, in PCCP group, showing significant difference (P<0.05). Avascular necrosis (AVN) in 17 cases in HCS group while 15 cases in PCCP group, showing no significant difference (P>0.05). The overall complications in HCS group were greater than that in PCCP group (P<0.05). The Harris hip scores at 6- and 12-month follow-up in group PCCP were significantly improved than those in group HCS (P<0.05), but not significant at 18-, 24- month and last follow-up between the two groups (P>0.05).
Conclusion: Our results suggest that PCCP is a stable and reliable internal fixation device with sliding compression effect for femoral neck fractures, which has satisfactory short and mid-term therapeutic effects, but AVN remains unsolved.
Keywords: Femoral neck fracture, multicentre, percutaneous compression plate, therapeutic effect