Abstract
Objective To compare the curative effects of Pauwels cannulated screws (PCS) and DHS-blade plus anti-rotation screw +anti-rotation screw(DHSA+AS) in the treatment of Pauwels type Ⅲ femoral neck fractures. Methods From December 2013 to December 2015, 46 patients with fresh Pauwels type Ⅲ femoral neck fracture were treated with internal fixation at our department. They were divided into 2 groups according to different fixation methods. In the DHSA+AS group of 25 patients, 13 were male and 12 female, with an average age of 49.2±8.2 years, and there were 3 cases of Garden type Ⅱ, 4 cases of Garden type Ⅲ and 18 cases of Garden type Ⅳ. In the PCS Group of 21 patients, 11 were male and 10 fe-male, with an average age of 48.7±6.2 years, and there were 2 cases of Garden type Ⅱ, 6 cases of Garden type Ⅲ and 13 cases of Garden type Ⅳ. The 2 groups were compared in terms of operation time, intraoper-ative blood loss, reduction quality, hospital stay, union time, postoperative complications and Harris hip score. Results DHSA+AS group needed significantly longer operation time (54.0±7.3 minutes) and incurred significantly more intraoperative blood loss (102.3±10.5 mL) than PCS group (46.3±5.4 minutes & 77.4±9.1 mL, respectively) (P 0.05). DHSA+AS group and PCS group obtained an average follow-up of 14.1±1.6 months and 13.7±1.2 months, respectively. For DHSA+AS group and PCS group, the rate of postoperative complications was respectively 12.0%(3/25) versus 4.8%(1/21), and the Harris hip score at the last follow-up respectively 83.6±5.4 versus 85.1±5.5, showing no significant dif-ferences between the 2 groups (P >0.05). Conclusions DHSA+AS and PCS are both suitable in-ternal fixation options for patients with Pauwels type Ⅲ femoral neck fracture when reduction is fine. Com-pared with DHSA+AS, PCS may need less operation time and incur less intraoperative blood loss. Key words: Femoral neck fractures; Fracture fixation, internal; Bone nails; Pauwels’ angle
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