Title:Radiological Evaluation of Effectiveness of PCCP Fixation for Femoral Neck
Fracture: Med-term Effectiveness in a Retrospective Multicenter
Volume: 20
Author(s): Wen Tang, Changbao Wei, Liansheng Dai, Dong Lu, Weichun Meng, Zihong Zhou, Sanjun Gu, Haifeng Li*Yanping Ding*
Affiliation:
- Department of Orthopaedic, Wuxi No. 9 People’s Hospital Affiliated to Soochow University, Wuxi 214062, Jiangsu, P.R. China
- Department of Radiology, Wuxi No. 9 People's Hospital, Affiliated to Soochow University, Wuxi 214062, Jiangsu, P.R. China
Keywords:
Femoral neck fractures, Multicenter, Percutaneous compression plate, Therapeutic effect, Radiology, Neck shortening.
Abstract:
Background:
It has been reported in the literature that the complication rate of percutaneous compression plate (PCCP) is the lowest among the new internal
fixators for the treatment of femoral neck fracture (FNS). However, no multicenter studies of PCCP for FNS have been reported. This study aimed
to evaluate the med-term effectiveness of PCCP in a multicenter mainly through radiology.
Methods:
265 patients with FNF treated with PCCP fixation in our five hospitals between January 2011 and December 2020 were retrospectively analyzed.
140 men and 125 women; aged 19–79 (mean 51.6)years. The follow-up time was 2-5 years (mean 3.1). Radiological evaluation of the therapeutic
effect was the main outcome, and the function was the secondary outcome.
Results:
One case of screw cutting out, 3 cases of screw back out, 25 cases of neck shortening, 2 cases of nonunion, 8 cases of delayed healing, and 29
cases of avascular necrosis (AVN). Bivariate correlation showed that shortening healing was correlated with age, Singh index, and Garden
alignment index, poor healing was correlated with garden alignment index, and AVN was correlated with Pauwels and Garden classifications and
operation timing. Further pairwise comparison analysis showed that age of > 65 and Singh index IV were dangerous factors for neck shortening,
and the operation timing > 3 days, Pauwels II and III, and Garden III and IV were dangerous factors for AVN. The excellent and good rate of
function in 198 patients who were readmitted for internal fixator removal or other surgery was 90.9%.
Conclusion:
PCCP for FNS has satisfactory med-term efficacy with a low complication rate. The main complication is AVN, which is prone to occur in patients
with displaced Pauwels II or III FNF and operation timing > 3 days. Another main complication is shortening healing, which is prone to occur in
patients with an age of > 65 and Singh index IV.
