Treatment Of Femoral Head Fractures With Osteochondral Covering On Absorbable Screw

Part 1 Animal experimentsObjective:To investigate the effect of osteochondral covering on absorbable screw on the osteochondral repair.Methods:An osteochondral column of diameter 4mm and thickness 3.5mm will be remove from 20 mature New Zealand White rabbits knees trochlear groove of femoral condyle. An appropriate size absorbable screw (rod) will be put into the right knee trochlear groove of femoral condyle and the osteochondral column will be replant cover the absorbable rod;The absorbable rod will be just replantation without absorbable screw (rod) for Control as to the left knee. The scheduled time points of animal euthanization will be at 4weeks,8 weeks and 16weeks. The specimens will be harvested for normal observation and morphology analysis of osteochondral repair.Result:There are not significantly (P>0.05) between the two groups as to normal observation and morphology analysis on all the scheduled time points.Conclusion:Osteochondral covering on absorbable screw has no significant interference to the osteochondral repair. key words:Absorbable screw,cover,osteochondral repair Part 2 Clinical trialsObjective:To investigate the use of osteochondral covering on absorbable screw for the treatment of femoral head fractures.Methods 38 cases with femoral head fractures were classified into 4 groups according to Pipkin classification system:12 cases were type 1,16 cases were type II,2 case were type III,8 cases were type IV. Absorbable screw will be used in all of the case; Proximal femoral buttress plate fixation will be used for The femoral neck fracture of groupsIII; Smaller pieces of acetabular fractures in tape IV could be removed, big pieces could be fixed by re-absorbable screw or plate fixation.Results No wound infection occurred in all patients and all patients were discharged eventlessly. ALL the 35 cases were followed up for 2-63 months, with an average follow-up of 25 months. In the 35 cases:excellent in 20 cases, good in 10cases, fair in 4cases and poor in 1 case.Conclusion Osteochondral covering on absorbable screw which were banned using for intra-articular fractures before is practical and effective for the treatment of Pipkin I, II, III, IV-type femoral head fractures.