Does the Method of Fixation Affect the Risk of Complications in Patients with Pauwels Type 3, Displaced Intracapsular Femoral Fractures

Abstract

Background: Patients with Pauwels type III displaced intracapsular femoral fractures (DICFF) are at a high risk of developing avascular necrosis (AVN) and non-union following closed reduction and internal fixation (CRIF). We compared the complications between the Targon femoral neck (TFN) plate and the cannulated cancellous screws (CCS). Methods: This retrospective study reviewed the records of 34 patients younger than 65 years of age who underwent CRIF of Pauwels type III DICFF from January 2007 to January 2018. Patients were evaluated for demographic data as well as the fixation method. Subsequent postoperative radiographs were obtained to assess the incidence of AVN and nonunion. Results: 34 patients were included in the study, of which, 18 (53%) and 16 (47%) were treated using TFN and CCS, respectively There were no significant differences observed between the CCS and TFN cohorts in terms of age (p = 0.90), gender (p = 0.27), time to surgery (p = 0.36), and duration of surgery (p = 0.99). The incidence of AVN and non-union did not significantly differ between the groups, with rates of 38.9% and 43.8%, respectively (p = 0.083) Conclusions: The type of fixation utilized, whether CCS or TFN, did not have a significant impact on the incidence of treatment failure in patients with Pauwels type III fractures treated via CRIF