The Role of The Medial Buttress Plate In The Treatment of Pauwels Type Ⅱ And Ⅲ Femoral Neck Fracture: A Retrospective Study And Preliminary Results

Abstract

Background: The purpose of this study was to compare the effectiveness of multiple cannulated screws combined with medial buttress plate or not for the treatment of unstable femoral neck fracture.Methods: 69 nonelderly patients with Garden type III-IV femoral neck fracture were retrospectively analyzed. The patients were divided into MCS (multiple cannulated screws) group and CMBP (combined with medial buttress plate) group according to the surgical method. Patient’s demographic data, Harris Hip Score, EQ-5D index and complications at minimum of 2 years follow-up were analyzed.Results: There were 47 patients in the MCS group (35 male and 12 females) with a mean age of 40.28±12.64 years, whereas 22 patients in the CMBP group (17 male and 5 females) with a mean age of 43.86±12.55 years. In the MCS group, there were one avascular necrosis, five postoperative nonunion, five implant failure, and two femoral neck shortening. While one implant failure, two postoperative nonunion and two impingement in the CMBP group. The difference of HHS scores was statistically significant at 3 months after surgery between the two groups (P<0.05), whereas there was no statistical significance at 6 months, 1 year and 2 years (P>0.05). The same results were found in EQ-5D index.Conclusions: Anatomic reduction and stable fixation contribute to satisfactory outcomes in the treatment of nonelderly displaced femoral neck fractures. A buttress plate in the medial region of the femur neck with cannulated screws offers patients the best biomechanical microenvironment needed for fracture healing without obviously blood-supply disruption, especially in Pauwels type Ⅱ and III.