Midterm Results Of Percutaneous Compression Plate Of Femoral Neck Fractures In Young And Middle-aged Patients

Background:Hip fractures account for up to 5 million disability cases worldwide every year,and femoral neck fractures account for about 50%of these cases.With the development of society and the increase of life expectancy,the incidence of hip fracture will further increase,and the mortality rate within one year is as high as 14%-36%.The femoral neck is one of the parts of the most powerful parts of the body.Once fracture occurs,it will cause serious burden to society,family and individual.How to treat patients quickly and effectively,help them return to normal life as soon as possible,and reduce the incidence of long-term complications,is the goal of doctors.At the same time,with the further understanding of the anatomical and mechanical structure of the femoral neck,combined with the treatment experience of internal fixation,many new internal fixation devices have been designed,which have certain advantages over the traditional internal fixation,but still need further research to prove.Objective:Femoral neck fracture is one of the common fractures in clinical treatment.As the mainstream treatment,internal fixation has the advantages of less trauma,quick recovery and simple operation,but it also faces two major complications,nonunion of femoral neck fracture and femoral head necrosis.This study investigated the medium-term efficacy of Percutaneous Compression Plate(PCCP)in the treatment of femoral neck fractures in young and middle-aged adults.Methods:173 young and middle-aged patients with femoral neck fracture treated with PCCP from December 2010 to March 2019 were retrospectively analyzed.There were 102 males and 71 females,with an age of(44.9±11.4)years.General information,perioperative data and follow-up data were collected and recorded,including gender,age,cause of injury,time from injury to operation,underlying disease,operation time,blood loss,blood transfusion volume,Harris joint score and complications.The reduction quality and complications of closed reduction and fixed PCCP implantation were analyzed,and the therapeutic effect of PCCP was finally evaluated.Results:The one hundred and seventy-three patients in our cases were followed up for(42.6±21.0)months.The reduction quality of one hundred and seventy patients were satisfied and three were unsatisfied.There were 156 excellent cases,11 good cases,3 tolerable cases and 3 fair case for the Harris scores at final follow-up,with the excellent-good rate of 96.5%.Except for one case of nonunion,the healing time of fractures was(3.6±0.8)months.In the aspect of complications,the incidence of femoral head necrosis was 7.5%(13/173)including 2 undisplaced fractures and 11 displaced fractures.The shortening of femoral neck was 2.9%(5/173).The loosening of screw was 1.2%(2/173).The cutout of screw was 0.6%(1/173).The nonunion was 0.6%(1/173)and two patients had delayed union(1.2%).Conclusion:The treatment of femoral neck fractures with PCCP have advantages of rigid fixation,immediate weight-bearing and sliding compression,reducing the occurrence of nonunion and the incidence of femoral head necrosis.