Pauwels cannulated screws versus DHS-blade plus anti-rotation screw for treatment of Pauwels type Ⅲ femoral neck fractures
10.3760/cma.j.issn.1671-7600.2017.11.005
- VernacularTitle:Pauwels空心螺钉与动力髋螺旋刀片系统加防旋螺钉治疗Pauwels Ⅲ型股骨颈骨折的近期疗效比较
- Author:
Wei WANG
1
;
Jun YANG
;
Hailun GU
;
Jianjun LI
;
Lifeng DING
;
Zhan WANG
Author Information
1. 中国医科大学附属盛京医院骨科
- Keywords:
Femoral neck fractures;
Fracture fixation,internal;
Bone nails;
Pauwels' angle
- From:
Chinese Journal of Orthopaedic Trauma
2017;19(11):948-954
- CountryChina
- Language:Chinese
-
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 female,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,intraoperative 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).There were no significant differences between the 2 groups in reduction quality,hospital stay,or union time (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％ (1/91),and the Harris hip score at the last follow-up respectively 83.6 ± 5.4 versus 85.1 ± 5.5,showing no significant differences between the 2 groups (P ＞ 0.05).Conclusions DHSA + AS and PCS are both suitable internal fixation options for patients with Pauwels type Ⅲ femoral neck fracture when reduction is fine.Compared with DHSA + AS,PCS may need less operation time and incur less intraoperative blood loss.
