Abstract:Objective To study the application of cannulated screw combined with medial buttress plate in the treatment of Pauwels typeⅢ femoral neck fracture.Methods From November 2015 to October 2018,58 patients with Pauwels type Ⅲ femoral neck fractures who met the inclusion criteria wereenrolled and randomly divided into two groups:cannulated screw,cannulated screwscombined with medial buttress plate,with 29 cases in each group.The average operation time,intraoperative blood loss,intraoperative fluoroscopy,postoperative complications (such as nail removal,nonunion,femoral head necrosis rate,hip varus,femoral neck shortening,etc.) were observed and compared between the two groups.Harris Hip Score at 6,12and 24 months after operation were used to assess hip joint function.Results All patients were followed up 24~56 months,with an average of (30.6±6.1)months.(1)Compared with the cannulated screw group,the average operation time and intraoperative blood loss of the cannulated screwcombined with medial buttress plate group were longer and more,but the time of intraoperative fluoroscopy was less,and the difference was statistically significant (P<0.05).(2) The excellent and good rate of fracture reduction in cannulated screwcombined with medial buttress plate group is high,and the difference is statistically significant.(3) The incidence of postoperative complications such as screw withdrawal,femoral head necrosis,hip varus,and femoral neck shortening in cannulated screw combined withmedial buttress plate group was lower than that of the cannulated screw group,and the difference was statistically significant (P<0.05).The incidence of nonunion was similar between the two groups,and the difference was not statistically significant (P>0.05).(4)Compared with the cannulated screw group,the Harris Hip Score of the cannulated screw combined with medial buttress plate group was significantly higher at 6,12,and 24 months after surgery,and the difference was statistically significant.(P<0.05).Conclusion Cannulated screw combined with medial buttress plate is more effective in the treatment of Pauwels tape Ⅲ femoral neck fracture.and the postoperative complication rate is low,which can provide a reference for clinical treatment of this type of fracture.
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