Abstract
Objective To compare the clinical effect of proximal femoral locking plate (PFLP) versus multiple cancellous screw (MCS) for FNF. Methods FNF patients were treated with the PFLP implant or multiple cancellous screws (MCSs). Patient has been followed up for at least 12 months after surgery nonunion, and the occurrence of complications, femoral neck shortening, fracture healing time, and Harris hip score were recorded and compared. Results 77 FNF patients were treated with the PFLP (36 patients) or MCS (41 patients). The sex, age, side of the injured limb, type of Garden fracture, time from injury to surgery, and fracture healing time of two groups patients were comparable. The operation time and intraoperative blood loss in the PFLP group were worse than those in the MCS group. Two patients with the PFLP (5%) and nine patients (21%) with the MCS experienced cut out of the lag screw or avascular necrosis of the femoral head or nonunion and received hip replacement. However, the number of fluoroscopies in the PFLP group was significantly lower than that in the MCS group. Additionally, the femoral neck shortening and Harris hip score were all strongly better in the PFLP group than in the MCS group. Conclusions Compared with the MCS, PFLP treatment for FNF in young adults can decrease the fluoroscopy times, improve hip functional recovery, and reduce the complications rate and femoral neck shortening.
Highlights
Femoral neck fracture (FNF) is one of the most common types of fractures, and the lower limb of patients cannot move and the quality of life is severely affected [1]
Two patients with the proximal femoral locking plate (PFLP) (5%) and 9 patients (21%) with the multiple cancellous screw (MCS) were diagnosed with postoperative complications. e time to implant failure in the PFLP group and MCS group was 2.3 months and 3.2 months, respectively. e number of PFLP fluoroscopy was lower
In the PFLP group, femur shortening is 27 (75%), 6 (16.67%), and 3 (8.33%) for mild, moderate, and severe, respectively, while 26 (63.42%), 16 (39.02%), and 9 (2.2%) in the MCS group, respectively. e fracture healing time in PFLP and MCP groups was (4.82 ± 2.25) months and (4.52 ± 1.76) months, respectively. ere was 1 (2.78%) case each of nonunion and crew-out, and 2 (5.56%) cases underwent total hip arthroplasty
Summary
Femoral neck fracture (FNF) is one of the most common types of fractures, and the lower limb of patients cannot move and the quality of life is severely affected [1]. Osteoporosis is the main cause of FNF, and FPF patients are mainly manifested as lower limb shortening and abduction. The PFLP has its own advantages, including the ability to anatomically fit the proximal femur, and the locking screw can be fixed to the femoral head and femoral neck at multiple points [4, 5]. Since 2016, a new internal fixation setting was used to treat FNF in young adults during the operation of the PFLP. We compared the clinical effects of the PFLP and multiple cancellous screw (MCS) on treating FNF patients. The present is the first attempt at comparing the complications and function after the use of the PFLP versus the conventional fixation method
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