Biomechanical study on the treatment of Pauwels type III femoral neck fracture by open reduction and internal fixation with hollow nail internal fixation

J.-J. Liu, Z.-L. Wang, L.-Y. Zhang, K. Sun, J. Li, Z.-Z. Li, Z.-Y. Cao

Department of Orthopedic, Jiujiang University Clinical Medical College, Jiujiang, Jiangxi, China. jjfygk@outlook.com

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• Orthopedics

OBJECTIVE: We aimed to explore the therapeutic effect of open reduction and internal fixation with hollow nail internal fixation for Pauwels type Ⅲ femoral neck fracture.

PATIENTS AND METHODS: From January 2016 to February 2021, a total of 100 eligible patients with Pauwels type III femoral neck fracture were involved in this study and divided into two groups randomly: the combined remedy group and the closed therapy group, with 50 patients in each group. After that, 50 subjects in the combined remedy group were treated with open reduction and support plate combined with hollow screw internal fixation, and the treatment conditions were observed and recorded. The closed therapy group received routine treatment.

RESULTS: Among the 100 patients selected, the operation time of the combined remedy group was significantly lower than that of the closed therapy group, and the intraoperative bleeding was also significantly less. In the closed therapy group, the time of getting out of bed after the operation and the excellent and good rate were better; moreover, the functional score and pain score of three months after the operation were significantly better than that of one month after the operation. The functional score and pain score of one month after the operation were not statistically significant for the combined remedy group or the closed therapy group.

CONCLUSIONS: In the treatment of Pauwels type Ⅲ femoral neck fracture with open reduction and internal fixation combined with hollow nail internal fixation, the operation time and intraoperative bleeding volume were significantly decreased, but the postoperative recovery time was enhanced compared to that of total joint replacement. After the operation, the functional score and pain score had a significant relationship with the recovery time, and there was no significant relationship with the type of treatment. Therefore, in clinical treatment, doctors should take appropriate treatment methods for their patients.

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