The Role of Medial Buttress Plate Augmentation of Cannulated Screws in Unstable Femoral Neck Fractures: A Pilot Study

Sayyed Hadi Sayyed Hoseinian; Ali Birjandi Nejad; Farshid Bagheri; Mohammad Taghi Peivandi; Ehsan Vahedi; Amin Razi; Ghasem Zamani; Ali Parsa

doi:10.18502/jost.v7i1.5960

Sayyed Hadi Sayyed Hoseinian Assistant Professor, Department of Orthopedic Surgery, Shahid Kamyab Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Ali Birjandi Nejad Associate Professor, Department of Orthopedic Surgery, Shahid Kamyab Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Farshid Bagheri Assistant Professor, Department of Orthopedic Surgery, Shahid Kamyab Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Mohammad Taghi Peivandi Specialist in Orthopedic Surgery, Department of Orthopedic Surgery, Shahid Kamyab Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Ehsan Vahedi Associate Professor, Department of Orthopedic Surgery, Shahid Kamyab Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Amin Razi Specialist in Orthopedic Surgery, Department of Orthopedic Surgery, Shahid Kamyab Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Ghasem Zamani Associate Professor, Department of Orthopedic Surgery, Shahid Kamyab Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Ali Parsa Associate Professor, Department of Orthopedic Surgery, Shahid Kamyab Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

DOI: https://doi.org/10.18502/jost.v7i1.5960

Keywords: Bone Plates; Bone Screws; Femoral Neck Fractures; Fracture Fixation; Surgical Fixation Devices

Abstract

Background: About 20% of femoral neck fracture surgeries require re-operation. The use of medial buttress plate may reduce the reoperation rate. The purpose of this study is to examine the results of using the method of augmentation of the cannulated screws with medial buttress plate for treatment of unstable femoral neck fractures.

Methods: This study included patients with femoral neck fractures of Pauwels type 2 and 3 in which closed reduction was not successful. The patients underwent open anatomical reduction and implantation of three screws, and then the medial placement of the buttress plate was performed. Patients were followed up after 2 weeks, 6 weeks, 3 months, and 6 months. Union and fracture healing and operative complications were assessed using plain radiography.

Results: This study included 8 patients with Pauwels type 2 and 3 femoral neck fractures. All patients were men with the mean age of 38.0 ± 11.3 years. Re-hospitalization 30 days after surgery, surgical site infection, deep vein thrombosis (DVT), and deep infection were not observed in any of the patients. The angle between the neck and the femur shaft dramatically increased during the 6-month follow-up (P = 0.049). Union occurred in 6 (75%) patients after 6 months, while 2 patients were lost to follow up. Participants’ Harris Hip Score (HHS) had a significant improvement from 3 months to 6 months after surgery (P = 0.02).

Conclusion: Augmentation of cannulated screws with medial buttress plate for unstable femoral neck fractures in patients has advantages in short-term clinical follow-up.