Effectiveness of F-shaped screw fixation technique in treatment of Pauwels type <b>Ⅲ</b> femoral neck fractures _Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 WANG Feng , LIU Yu , ZHANG Changcheng

Department of Orthopaedics, Central Hospital of Nanyang, Nanyang Henan, 473000, P.R.China;

Corresponding?author：

WANG Feng, Email: 1226658520@qq.com

Keywords：

Femoral neck fracture; screw; internal fixation; F-shaped screw fixation technique

DOI：

10.7507/1002-1892.201805111

Video：

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Objective To summarize the effectiveness of F-shaped screw fixation technique in treatment of Pauwels type Ⅲ femoral neck fractures. Methods Between January 2013 and December 2016, 43 patients with Pauwels type Ⅲ femoral neck fractures were treated with F-shaped screw fixation technique. There were 32 males and 11 females with an average age of 38.9 years (range, 20-55 years). The fractures located on the left side in 21 patients and on the right side in 22 patients. The cause of injury included traffic accident in 19 patients and falling from height in 24 patients. There were 25 patients of Garden type Ⅲ and 18 of Garden type Ⅳ. The time from injury to operation was 2-3 days (mean, 2.2 days). These data were recorded, including operative time, fluoroscopy time, postoperative hospital stay, quality of reduction, postoperative complications (nonunion, varus deformity, femoral neck shortening, avascular necrosis of femoral head, screws back-out), and Harris scores. Results The operative time was 28-45 minutes (mean, 37.5 minutes). The fluoroscopy time was 13-20 seconds (mean, 14.7 seconds). The postoperative hospital stay was 2-3 days (mean, 2.7 days). All incisions healed by first intention. All patients were followed up 18–58 months with an average of 38.7 months. All patients have anatomical reduction of fractures. Fracture healing occurred in 42 patients; the union time was 3-5 months with an average of 3.6 months. Nonunion occurred in 1 patient who was treated with total hip arthroplasty. Of the 42 patients with fracture healing, 11 cases had a femoral neck shortening, 9 cases had varus deformity, 3 cases had avascular necrosis of femoral head, and 8 cases had screws back-out. There was no significant difference in complication incidences between Garden type Ⅲ fractures and Garden type Ⅳ fractures (P>0.05). Conclusion Treatment of femoral neck fractures by using the F-shaped screw fixation technique, can achieve satisfactory effectiveness with less postoperative complication.

Citation： WANG Feng, LIU Yu, ZHANG Changcheng. Effectiveness of F-shaped screw fixation technique in treatment of Pauwels type Ⅲ femoral neck fractures . Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(11): 1417-1420. doi: 10.7507/1002-1892.201805111 Copy

1.	劉志榮, 葛云林, 丁舒晨, 等. 多軸鎖定鋼板內固定治療中老年股骨頸骨折的近期療效觀察. 中國修復重建外科雜志, 2017, 31(1): 5-10.
2.	龍亞周, 張樹明, 王奎友, 等. 股骨頸骨折空心釘固定閉合復位治療策略. 中國修復重建外科雜志, 2016, 30(7): 809-814.
3.	Papanastassiou ID, Mavrogenis AF, Kokkalis ZT, et al. Fixation of femoral neck fractures using divergent versus parallel cannulated screws. J Long Term Effort Med Implants, 2011, 21(1): 63-69.
4.	Weil YA, Khoury A, Zuaiter I, et al. Femoral neck shortening and varus collapse after navigated fixation of intracapsular femoral neck fractures. J Orthop Trauma, 2012, 26(1): 19-23.
5.	Filipov O. Biplane double-supported screw fixation (F-technique): a method of screw fixation at osteoporotic fractures of the femoral neck. Eur J Orthop Surg Traumatol, 2011, 21(7): 539-543.
6.	Tai TW, Lien FC, Lee PY, et al. Using a cannulated screw as a drill guide and sleeve: a simple technique for multiple-screw fixation for intracapsular femoral neck fracture. Orthopedics, 2010, 33(8): 549.
7.	Sprague S, Schemitsch EH, Swiontkowski M, et al. Factors associated with revision surgery after internal fixation of hip fractures. J Orthop Trauma, 2018, 32(5): 223-230.
8.	Ma JX, Kuang MJ, Xing F, et al. Sliding hip screw versus cannulated cancellous screws for fixation of femoral neck fracture in adults: A systematic review. Int J Surg, 2018, 52: 89-97.
9.	Weil YA, Qawasmi F, Liebergall M, et al. Use of fully threaded cannulated screws decreases femoral neck shortening after fixation of femoral neck fractures. Arch Orthop Trauma Surg, 2018, 138(5): 661-667.
10.	Papanastassiou ID, Mavrogenis AF, Kokkalis ZT, et al. Fixation of femoral neck fractures using divergent versus parallel cannulated screw. J Long Term Eff Med Implants, 2011, 21(1): 63-69.
11.	Galal S, Nagy M. Non-parallel screw fixation for femoral neck fractures in young adults. J Clin Orthop Trauma, 2017, 8(3): 220-224.
12.	Yin H, Pan Z, Jiang H. Is dynamic locking plate (Targon FN) a better choice for treating of intracapsular hip fracture? A meta-analysis Int J Surg, 2018, 52: 30-34.
13.	Lu-Yao GL, Keller RB, Littenberg B, et al. Outcomes after displaced fractures of the femoral neck. A meta-analysis of one hundred and six published reports. J Bone Joint Surg (Am), 1994, 76(1): 15-25.
14.	李偉龍, 余霄, 龐清江. 股骨頸骨折內固定術后股骨頸短縮的相關研究進展. 中華骨科雜志, 2016, 36(6): 378-384.

1. 劉志榮, 葛云林, 丁舒晨, 等. 多軸鎖定鋼板內固定治療中老年股骨頸骨折的近期療效觀察. 中國修復重建外科雜志, 2017, 31(1): 5-10.
2. 龍亞周, 張樹明, 王奎友, 等. 股骨頸骨折空心釘固定閉合復位治療策略. 中國修復重建外科雜志, 2016, 30(7): 809-814.
3. Papanastassiou ID, Mavrogenis AF, Kokkalis ZT, et al. Fixation of femoral neck fractures using divergent versus parallel cannulated screws. J Long Term Effort Med Implants, 2011, 21(1): 63-69.
4. Weil YA, Khoury A, Zuaiter I, et al. Femoral neck shortening and varus collapse after navigated fixation of intracapsular femoral neck fractures. J Orthop Trauma, 2012, 26(1): 19-23.
5. Filipov O. Biplane double-supported screw fixation (F-technique): a method of screw fixation at osteoporotic fractures of the femoral neck. Eur J Orthop Surg Traumatol, 2011, 21(7): 539-543.
6. Tai TW, Lien FC, Lee PY, et al. Using a cannulated screw as a drill guide and sleeve: a simple technique for multiple-screw fixation for intracapsular femoral neck fracture. Orthopedics, 2010, 33(8): 549.
7. Sprague S, Schemitsch EH, Swiontkowski M, et al. Factors associated with revision surgery after internal fixation of hip fractures. J Orthop Trauma, 2018, 32(5): 223-230.
8. Ma JX, Kuang MJ, Xing F, et al. Sliding hip screw versus cannulated cancellous screws for fixation of femoral neck fracture in adults: A systematic review. Int J Surg, 2018, 52: 89-97.
9. Weil YA, Qawasmi F, Liebergall M, et al. Use of fully threaded cannulated screws decreases femoral neck shortening after fixation of femoral neck fractures. Arch Orthop Trauma Surg, 2018, 138(5): 661-667.
10. Papanastassiou ID, Mavrogenis AF, Kokkalis ZT, et al. Fixation of femoral neck fractures using divergent versus parallel cannulated screw. J Long Term Eff Med Implants, 2011, 21(1): 63-69.
11. Galal S, Nagy M. Non-parallel screw fixation for femoral neck fractures in young adults. J Clin Orthop Trauma, 2017, 8(3): 220-224.
12. Yin H, Pan Z, Jiang H. Is dynamic locking plate (Targon FN) a better choice for treating of intracapsular hip fracture? A meta-analysis Int J Surg, 2018, 52: 30-34.
13. Lu-Yao GL, Keller RB, Littenberg B, et al. Outcomes after displaced fractures of the femoral neck. A meta-analysis of one hundred and six published reports. J Bone Joint Surg (Am), 1994, 76(1): 15-25.
14. 李偉龍, 余霄, 龐清江. 股骨頸骨折內固定術后股骨頸短縮的相關研究進展. 中華骨科雜志, 2016, 36(6): 378-384.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of F-shaped screw fixation technique in treatment of Pauwels type Ⅲ femoral neck fractures

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