Login Register Cart 0
Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Radiological Evaluation of Effectiveness of PCCP Fixation for Femoral Neck Fracture: Med-term Effectiveness in a Retrospective Multicenter

Author(s): Wen Tang, Changbao Wei, Liansheng Dai, Dong Lu, Weichun Meng, Zihong Zhou, Sanjun Gu, Haifeng Li* and Yanping Ding*

Volume 20, 2024

Published on: 07 July, 2023

Article ID: e020623217604 Pages: 7

DOI: 10.2174/1573405620666230602123016

Price: $65

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.

[1]
Shaikh SA, Hussain S, Ali Samejo MQ, Ahmed N, Jamali AR. Osetosynthesis of Fractures neck femur with cannulated screws: Evaluation of risk factors for post-operative complications. J Pak Med Assoc 2021; 71(Supp5): S59-63.
[PMID: 34634018]
[2]
Ju F, Hou R, Xiong J, Shi H, Chen Y, Wang J. Outcomes of femoral neck fractures treated with cannulated internal fixation in elderly patients: a long-term follow-up study. Orthop Surg 2020; 12(3): 809-18.
[http://dx.doi.org/10.1111/os.12683] [PMID: 32462816]
[3]
Chiang MH, Wang CL, Fu SH, Hung CC, Yang RS. Does fully-threaded Headless Compression Screw provide a length-stable fixation in undisplaced femoral neck fractures? Asian J Surg 2019; 42(1): 320-5.
[http://dx.doi.org/10.1016/j.asjsur.2018.05.009] [PMID: 30037642]
[4]
Cintean R, Pankratz C, Hofmann M, Gebhard F, Schütze K. Early results in non-displaced femoral neck fractures using the femoral neck system. Geriatr Orthop Surg Rehabil 2021; 12
[http://dx.doi.org/10.1177/21514593211050153] [PMID: 34733579]
[5]
Damany DS, Parker MJ, Chojnowski A. Complications after intracapsular hip fractures in young adults. A meta-analysis of 18 published studies involving 564 fractures. Injury 2005; 36(1): 131-41.
[PMID: 15589931]
[6]
Luo D, Zou W, He Y, et al. Modified dynamic hip screw loaded with autologous bone graft for treating Pauwels type-3 vertical femoral neck fractures. Injury 2017; 48(7): 1579-83.
[http://dx.doi.org/10.1016/j.injury.2017.05.031] [PMID: 28583419]
[7]
Xiao YP, Shu DP, Bei MJ, Ji T, Kan WS, Li SG. The clinical application of a novel method of internal fixation for femoral neck fractures—dynamic locking compression system. J Orthop Surg Res 2018; 13(1): 131.
[http://dx.doi.org/10.1186/s13018-018-0827-9] [PMID: 29855311]
[8]
Shu DP, Xiao YP, Bei MJ, et al. Dynamic compression locking system versus multiple cannulated compression screw for the treatment of femoral neck fractures: A comparative study. BMC Musculoskelet Disord 2020; 21(1): 230.
[http://dx.doi.org/10.1186/s12891-020-03259-5] [PMID: 32284062]
[9]
Brandt SE. A new and stable implant in the treatment of the intracapsular hip fracture: A case report. Inj Extra 2008; 39(4): 137-9.
[http://dx.doi.org/10.1016/j.injury.2007.10.015]
[10]
Gomez-Vallejo J, Blanco-Rubio N, Lorenzo-Lopez R, et al. Outcomes of basicervical femoral neck fracture treated with percutaneous compression plate (PCCP). Injury 2021; 52 (Suppl. 4): S42-6.
[http://dx.doi.org/10.1016/j.injury.2021.03.062] [PMID: 34030863]
[11]
Mukherjee P, Ashworth MJ. A new device to treat intra-capsular fracture neck of femur non-union. Strateg Trauma Limb Reconstr 2010; 5(3): 159-62.
[http://dx.doi.org/10.1007/s11751-010-0096-6] [PMID: 21286362]
[12]
Osarumwense D, Tissingh E, Wartenberg K, et al. The Targon FN system for the management of intracapsular neck of femur fractures: minimum 2-year experience and outcome in an independent hospital. Clin Orthop Surg 2015; 7(1): 22-8.
[http://dx.doi.org/10.4055/cios.2015.7.1.22] [PMID: 25729515]
[13]
Zhu F, Liu G, Shao H, et al. Treatment of femoral neck fracture with percutaneous compression plate: Preliminary results in 74 patients. Orthop Surg 2015; 7(2): 132-7.
[http://dx.doi.org/10.1111/os.12170] [PMID: 26033994]
[14]
Wang T, Li R, Zhou J, et al. Midterm effectiveness of percutaneous compression plate for femoral neck fractures in young and middle-aged patients. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2022; 36(6): 708-13.
[PMID: 35712928]
[15]
Haidukewych GJ, Rothwell WS, Jacofsky DJ, Torchia ME, Berry DJ, Berry DJ. Operative treatment of femoral neck fractures in patients between the ages of fifteen and fifty years. J Bone Joint Surg Am 2004; 86(8): 1711-6.
[http://dx.doi.org/10.2106/00004623-200408000-00015] [PMID: 15292419]
[16]
Zhao D, Zhang F, Wang B, et al. Guidelines for clinical diagnosis and treatment of osteonecrosis of the femoral head in adults (2019 version). J Orthop Translat 2020; 21: 100-10.
[http://dx.doi.org/10.1016/j.jot.2019.12.004] [PMID: 32309135]
[17]
Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 1969; 51(4): 737-55.
[http://dx.doi.org/10.2106/00004623-196951040-00012] [PMID: 5783851]
[18]
Gotfried Y, Kovalenko S, Fuchs D. Nonanatomical reduction of displaced subcapital femoral fractures (Gotfried reduction). J Orthop Trauma 2013; 27(11): e254-9.
[http://dx.doi.org/10.1097/BOT.0b013e31828f8ffc] [PMID: 23481921]
[19]
Brandt E, Verdonschot N, van Vugt A, van Kampen A. Biomechanical analysis of the percutaneous compression plate and sliding hip screw in intracapsular hip fractures: Experimental assessment using synthetic and cadaver bones. Injury 2006; 37(10): 979-83.
[http://dx.doi.org/10.1016/j.injury.2006.05.011] [PMID: 16934259]
[20]
Zielinski SM, Keijsers NL, Praet SFE, et al. Femoral neck shortening after internal fixation of a femoral neck fracture. Orthopedics 2013; 36(7): e849-58.
[http://dx.doi.org/10.3928/01477447-20130624-13] [PMID: 23823040]
[21]
Nanty L, Canovas F, Rodriguez T, Faure P, Dagneaux L. Femoral neck shortening after internal fixation of Garden I fractures increases the risk of femoral head collapse. Orthop Traumatol Surg Res 2019; 105(5): 999-1004.
[http://dx.doi.org/10.1016/j.otsr.2019.05.009] [PMID: 31320235]
[22]
Araujo TPF, Guimaraes TM, Andrade-Silva FB, Kojima KE, Silva JS. Influence of time to surgery on the incidence of complications in femoral neck fracture treated with cannulated screws. Injury 2014; 45 (Suppl. 5): S36-9.
[http://dx.doi.org/10.1016/S0020-1383(14)70019-1] [PMID: 25528623]
[23]
Ramadanov N, Toma I, Herkner H, Klein R, Behringer W, Matthes G. Factors that influence the complications and outcomes of femoral neck fractures treated by cannulated screw fixation. Sci Rep 2020; 10(1): 758.
[http://dx.doi.org/10.1038/s41598-020-57696-2] [PMID: 31959840]
[24]
Slobogean GP, Sprague SA, Scott T, Bhandari M. Complications following young femoral neck fractures. Injury 2015; 46(3): 484-91.
[http://dx.doi.org/10.1016/j.injury.2014.10.010] [PMID: 25480307]
[25]
Wang Y, Ma J, Yin T, et al. Correlation between reduction quality of femoral neck fracture and femoral head necrosis based on biomechanics. Orthop Surg 2019; 11(2): 318-24.
[http://dx.doi.org/10.1111/os.12458] [PMID: 31025811]
[26]
Wang T, Sun JY, Zha GC, Jiang T, You ZJ, Yuan DJ. Analysis of risk factors for femoral head necrosis after internal fixation in femoral neck fractures. Orthopedics 2014; 37(12): e1117-23.
[http://dx.doi.org/10.3928/01477447-20141124-60] [PMID: 25437087]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy