• Jun-Feng Liu, Shao-Di Zhang, Liang Huang, Jiang-Hua Zhu, Xiao-Dong Hou, Shuo Ge, Tian-Long Wang, Shao-Hua Jia, Aquino Ernesto Da Graça Mandlate, Shu-Hao Liu, Zi-Fei Zhou, and Long-Po Zheng.
• Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.
• Injury. 2020 Aug 1; 51 (8): 1851-1857.

PurposePauwels type-3 femoral neck fractures are challenging injuries to manage with high rates of complications after internal fixation and no consensus has been reached regarding the optimal fixation construct. The current study aims to evaluate the effect of dynamic limited axial compression in parallel screws combined with medial buttress plate (SMBP) or lateral compression plate (LCP) fixation of Pauwels type-3 femoral neck fractures.MethodsWe performed a retrospective analysis of 51 cases of Pauwels type-3 femoral neck fractures who were fixed by SMBP or LCP. Specifically, the screw fixing the femoral head in the buttress plate was omitted. Postoperative complications and functional outcomes were mainly studied.ResultsWith a mean follow-up of 19.9 months, the rate of neck shortening was higher in the LCP group than that in SMBP group (32.1% vs. 8.7%, p = 0.04). Neither nonunion nor avascular necrosis was observed in both groups. Good-to-excellent Harris hip score accounts for 95.2% in SMBP group and 89.3% in LCP group (p = 0.40). Moreover, older age, fracture comminution and compression plate fixation predispose to neck shortening.ConclusionDynamic limited axial compression by SMBP or LCP fixation was effective to improve the functional outcome of patients with Pauwels type-3 femoral neck fractures.Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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