Analysis of the Therapeutic Effects of Percutaneous Compression Plate for Femoral Neck Fractures in Young and Middle-Aged Patients: A Retrospective Multicenter and 2-Year Follow-Up Study

Introduction: Traditional internal fixators include hollow compression screw (HCS) and sliding hip screw for femoral neck fractures have a high incidence of complications, and are not conducive to postoperative early rehabilitation and weight-loading of patients. Therefore, femoral neck fractures are referred to as ‘unresolved fractures’. However, single-center results of percutaneous compression plate (PCCP) have showed a significant improvement in efficacy. We retrospectively analyzed the therapeutic effects of PCCP for femoral neck fractures in young and middle-aged patients in a multi-center and >2-year follow-up.

Materials and Methods: Between January 2010 and December 2017, 331 patients with femoral neck fractures in young and middle-aged patients fixed with HCS and PCCP in four hospitals were studied retrospectively.

Results: There were 182 men and 149 women, with an average age of 47.69 years (age range, 20-65 years). HCS group vs. PCCP group (170 vs. 161). There was no significant difference in the baseline data between the two groups (P>0.05). All patients were followed-up for 24-60 months (mean, 36 months). The operative time and intraoperative bleeding were significantly decreased, whereas the hospital stay significantly longer in HCS group than those in PCCP group (P<0.05). Nonunion in 17 cases and fixation failure in 14 cases in HCS group, whereas 3 and 0 cases, respectively, in PCCP group, showing significant difference (P<0.05). Avascular necrosis (AVN) in 17 cases in HCS group while 15 cases in PCCP group, showing no significant difference (P>0.05). The overall complications in HCS group were greater than that in PCCP group (P<0.05). The Harris hip scores at 6- and 12-month follow-up in group PCCP were significantly improved than those in group HCS (P<0.05), but not significant at 18-, 24- month and last follow-up between the two groups (P>0.05).

Conclusion: Our results suggest that PCCP is a stable and reliable internal fixation device with sliding compression effect for femoral neck fractures, which has satisfactory short and mid-term therapeutic effects, but AVN remains unsolved.