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2000
Volume 21, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603

Abstract

Background:

The effects of percutaneous compression plate (PCP) internal fixation for femoral neck fractures (FNFs) in elderly individuals have rarely been reported. Therefore, this study aimed to investigate the efficacy of PCCP internal fixation for displaced FNFs in elderly individuals based on imaging.

Methods:

The clinical data of 32 elderly patients with FNFs treated with PCCP from January 2015 to December 2022 were retrospectively analyzed. The average age of the participants was 68.7 ± 4.8 years (range, 65–80 years). Nineteen patients had Garden type III, and 13 patients had Garden type IV. Six patients had Pauwels type I, 15 patients had type II, and 11 patients had type III. Twelve patients had Singh index level IV, 14 patients had level V, and 6 patients had level VI. The time from injury to operation ranged from 3–14 days, with an average of 5.8 days. A radiological assessment was conducted. The relationships between efficacy and age, Pauwels classification, the Singh index, and the Garden alignment index were analyzed.

Results:

At postoperative week 1, fracture reduction was acceptable in 31 patients. The time to start walking was 5.7 ± 3.7 days. The follow-up time ranged from 2.1 to 4 years, with an average of 2.7 years. There were 2 cases of delayed healing and no cases of nonunion or internal fixation failure. The healing time ranged from 4–8 months, with an average of 4.9 months. Fifteen patients (46.9%) showed healing with shortening of the femoral neck, and 3 patients (9.4%) had avascular necrosis (AVN). Correlation analysis revealed that healing with shortening of the femoral neck was positively correlated with age and the Singh index and that AVN was positively correlated with the Pauwels classification ( < 0.05).

Conclusion:

The efficacy of PCCPs for internal fixation of displaced FNFs in elderly individuals without severe osteoporosis is satisfactory, especially for patients who can ambulate early postoperatively. The main complications are healing with shortening of the femoral neck and AVN, which are prone to occur in patients with severe osteoporosis and Pauwels type III FNFs, respectively.

This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode
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2025-01-01
2026-01-02
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References

  1. MackeC. WernerM. HeroldL. KrauseO. GraulichT. ClausenJ.D. KrettekC. LiodakisE. No consequence for lateral view X-Ray in displaced proximal femoral fractures in the elderly.Front. Surg.2021865252810.3389/fsurg.2021.65252834109207
    [Google Scholar]
  2. FlorschutzA.V. LangfordJ.R. HaidukewychG.J. KovalK.J. Femoral neck fractures: current management.J. Orthop. Trauma201529312112910.1097/BOT.000000000000029125635363
    [Google Scholar]
  3. YeY. HaoJ. MauffreyC. HammerbergE.M. StahelP.F. HakD.J. Optimizing stability in femoral neck fracture fixation.Orthopedics2015381062563010.3928/01477447‑20151002‑0526488776
    [Google Scholar]
  4. GumustasS. TosunH.B. IsyarM. SerbestS. OznamK. BulutG. Femur neck fracture in young adults, is it really an urgent surgery indication: retrospective clinical study.Pan Afr. Med. J.20183011210.11604/pamj.2018.30.112.1364330364439
    [Google Scholar]
  5. SerbestS. TiftikçiU. TosunH.B. KısaÜ. The Irisin hormone profile and expression in human bone tissue in the bone healing process in patients.Med. Sci. Monit.2017234278428310.12659/MSM.90629328869754
    [Google Scholar]
  6. PengP. XiaoF. HeX. FangW. HuangJ. WangB. LuoY. ZhangQ. ZhangY. HeW. WeiQ. HeM. Global research status and trends of femoral neck fracture over the past 27 years: A historical review and bibliometric analysis.Front. Surg.2022987504010.3389/fsurg.2022.87504035784942
    [Google Scholar]
  7. CuiS. WangD. WangX. LiZ. GuoW. The choice of screw internal fixation and hemiarthroplasty in the treatment of femoral neck fractures in the elderly: a meta-analysis.J. Orthop. Surg. Res.202015143310.1186/s13018‑020‑01958‑232958029
    [Google Scholar]
  8. GiordanoV. PaesR.P. AlvesD.D. AmaralA.B. BelangeroW.D. GiordanoM. FreitasA. KochH.A. Stability of L-shaped and inverted triangle fixation assemblies in treating Pauwels type II femoral neck fracture: a comparative mechanical study.Eur. J. Orthop. Surg. Traumatol.20182871359136710.1007/s00590‑018‑2207‑x29693238
    [Google Scholar]
  9. MorochovičR. TakáčováK. TomčovčíkĽ. CiburP. BurdaR. Factors influencing femoral neck fracture healing after internal fixation with dynamic locking plate.Arch. Orthop. Trauma Surg.2019139562963810.1007/s00402‑018‑03103‑530617416
    [Google Scholar]
  10. ZhuF. LiuG. ShaoH. WangY. LiR. YangH. GengD. XuY. Treatment of femoral neck fracture with percutaneous compression plate: preliminary results in 74 patients.Orthop. Surg.20157213213710.1111/os.1217026033994
    [Google Scholar]
  11. StoffelK. ZdericI. GrasF. SommerC. EberliU. MuellerD. OswaldM. GueorguievB. Biomechanical evaluation of the femoral neck system in unstable Pauwels III femoral neck fractures: A comparison with the dynamic hip screw and cannulated screws.J. Orthop. Trauma201731313113710.1097/BOT.000000000000073927755333
    [Google Scholar]
  12. MukherjeeP. AshworthM.J. A new device to treat intra-capsular fracture neck of femur non-union.Strateg. Trauma Limb Reconstr.20105315916210.1007/s11751‑010‑0096‑621286362
    [Google Scholar]
  13. TangW. WeiC. DaiL. LuD. MengW. ZhouZ. GuS. LiH. DingY. Radiological evaluation of effectiveness of PCCP fixation for femoral neck fracture: med-term effectiveness in a retrospective multicenter.Curr Med Imaging2023201710.2174/157340562066623060212301637272459
    [Google Scholar]
  14. HaidukewychG.J. RothwellW.S. JacofskyD.J. TorchiaM.E. BerryD.J. Operative treatment of femoral neck fractures in patients between the ages of fifteen and fifty years.J. Bone Joint Surg. Am.20048681711171610.2106/00004623‑200408000‑0001515292419
    [Google Scholar]
  15. ZhaoD. ZhangF. WangB. LiuB. LiL. KimS.Y. GoodmanS.B. HernigouP. CuiQ. LineaweaverW.C. XuJ. DrescherW.R. QinL. Guidelines for clinical diagnosis and treatment of osteonecrosis of the femoral head in adults (2019 version).J. Orthop. Translat.20202110011010.1016/j.jot.2019.12.00432309135
    [Google Scholar]
  16. XuD.F. BiF.G. MaC.Y. WenZ.F. CaiX.Z. A systematic review of undisplaced femoral neck fracture treatments for patients over 65 years of age, with a focus on union rates and avascular necrosis.J. Orthop. Surg. Res.20171212810.1186/s13018‑017‑0528‑928187745
    [Google Scholar]
  17. JuF. HouR. XiongJ. ShiH. ChenY. WangJ. Outcomes of femoral neck fractures treated with cannulated internal fixation in elderly patients: A long-term follow-up study.Orthop. Surg.202012380981810.1111/os.1268332462816
    [Google Scholar]
  18. ZhaoJ. ShiH. JiangD. WangL. ChenS. JiaW. Analysis of combined indicators for risk of osteoporotic hip fracture in elderly women.Orthop. Surg.20211341205121210.1111/os.1297433942553
    [Google Scholar]
  19. BoraiahS. PaulO. HammoudS. GardnerM.J. HelfetD.L. LorichD.G. Predictable healing of femoral neck fractures treated with intraoperative compression and length-stable implants.J. Trauma201069114214710.1097/TA.0b013e3181bba23620010308
    [Google Scholar]
  20. YamamotoT. KobayashiY. NonomiyaH. Undisplaced femoral neck fractures need a closed reduction before internal fixation.Eur. J. Orthop. Surg. Traumatol.2019291737810.1007/s00590‑018‑2281‑030069691
    [Google Scholar]
  21. BrandtE. VerdonschotN. van VugtA. van KampenA. Biomechanical analysis of the percutaneous compression plate and sliding hip screw in intracapsular hip fractures: Experimental assessment using synthetic and cadaver bones.Injury2006371097998310.1016/j.injury.2006.05.01116934259
    [Google Scholar]
  22. BrandtS.E. A new and stable implant in the treatment of the intracapsular hip fracture: A case report.Inj. Extra200839413713910.1016/j.injury.2007.10.015
    [Google Scholar]
  23. JinZ.Y. GuC. YangH.L. XuM. Outcome of percutaneous compression plate for treatment of femoral neck fractures: mean follow-up of 4.4 years.Int. Orthop.20224681891189810.1007/s00264‑022‑05405‑135461392
    [Google Scholar]
  24. WangT. LiR. ZhouJ. XuM. GengD. XuY. ZhuF. Midterm effectiveness of percutaneous compression plate for femoral neck fractures in young and middle-aged patients.Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi202236670871310.7507/1002‑1892.20220205335712928
    [Google Scholar]
  25. ChenY. LiH. DaiL. YinQ. LiD. WangX. Imaging observation of percutaneous compression plate use in promoting femoral neck fracture healing.J. Int. Med. Res.20214980300060521103350110.1177/0300060521103350134407688
    [Google Scholar]
  26. KellyM.A. McSorleyK. CaseyM.C. ShannonF.J. The long-term outcomes following internal fixation for intracapsular hip fractures in an Irish tertiary referral centre.Ir. J. Med. Sci.201918841227123110.1007/s11845‑019‑01972‑230712244
    [Google Scholar]
  27. WangY. MaJ. YinT. HanZ. CuiS. LiuZ. MaX. Correlation between reduction quality of femoral neck fracture and femoral head necrosis based on biomechanics.Orthop. Surg.201911231832410.1111/os.1245831025811
    [Google Scholar]
  28. LiY. SunD. WangK. LiuJ. WangZ. LiuY. Postoperative avascular necrosis of the femoral head in pediatric femoral neck fractures.PLoS One2022175e026805810.1371/journal.pone.026805835551330
    [Google Scholar]
  29. LiZ. ZhangX. LiZ. PengA. ZhangL. DengY. SongL. Comparative study of Pauwels type III femoral neck fractures managed by short dynamic hip screw with fibula bone graft or cannulated screws in young adults.Ann. Transl. Med.202081168110.21037/atm‑19‑334432617301
    [Google Scholar]
  30. LuoD. ZouW. HeY. XianH. WangL. ShenJ. LianK. LinD. Modified dynamic hip screw loaded with autologous bone graft for treating Pauwels type-3 vertical femoral neck fractures.Injury20174871579158310.1016/j.injury.2017.05.03128583419
    [Google Scholar]
  31. SerbestS. TiftikçiU. TosunH.B. GümüştaşS.A. UludagA. Is there a relationship between fracture healing and mean platelet volume?Ther. Clin. Risk Manag.2016121095109910.2147/TCRM.S10879027471388
    [Google Scholar]
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