Comparison between hollow screws and Locking Compression Paediatric Hip Plate for displaced femoral neck fractures in children

Abstract

Objective To compare the efficacy of hollow screws and Locking Compression Paediatric Hip Plate(LCP PHP)in the treatment of displaced femoral neck fractures in children. Methods From January 2011 to March 2015, 38 children with displaced femur neck fracture received open reduction at our department after unsuccessful closed reduction. Twenty-one children underwent internal fixation with hollow screws, including 14 boys and 7 girls with an average of 8. 0 ±2. 4 years while 17 children underwent LCP PHP fixation, including 11 boys and 6 girls with an average of 7. 8 ± 2. 0 years. The 2 groups were compared in terms of operation time, intraoperative bleeding, loss of neck-shaft angle, union time, and Ratliff and Harris hip scores at the final follow-ups. Results There were no significant differences between the 2 groups in follow-up time, union time, or Ratliff or Harris hip scores at the final follow-ups( P> 0. 05). There was no significant difference between the 2 groups either in avascular necrosis(14. 2% for the hollow screw group versus 11. 8% for the LCP PHP group)( P> 0. 05). In the hollow screw group, the operation time(90. 2 ±18. 9 min)was significantly shorter, the blood loss(32. 4 ±18. 7 mL)significantly less, and the loss of neck-shaft angle(2. 96°±0. 74°)significantly greater than those in the LCP PHP group(125. 1 ±20. 6 min, 57. 7 ±22. 1 mL and 1. 22° ±0. 39°, respectively)(P<0. 05). Conclusions In management of unsuccessful closed reduction of displaced femoral neck fractures in children, open reduction and internal fixation with hollow screws may be similar to LCP PHP fixation in fracture healing time, postoperative complications and function assessment. However, hollow screws can lead to less bleeding and shorter operation time while LCP PHP can reduce loss of neck-shaft angle. Key words: Femoral neck fractures; Fracture fixation, internal; Bone nails; Children