Outcome analysis of post reduction pauwels angle in fracture neck of femur treated with dynamic hip screw or 6.5 mm cancellous cannulated screw fixation
Keywords:
Fracture neck of femur, Post reduction Pauwels angle, Dynamic hip screw, Cannulated cancellous screw and Union
Abstract
Introduction: Fracture within the neck region of intracapsular area of hip known as fracture neck of femur. Radiologically breakage in shenton’s line is diagnosed as a fracture of neck of femur. Still this fracture remains an enigma to the Orthopaedic surgeon and is called as unsolved fracture.
Aim of study: This study is undertaken to assess the correlation between post reduction Pauwel’s angle and union rate in the fracture neck of femur treated with either Dynamic Hip Screw or Cannulated Cancellous Screw fixation.
Materials and Methods: This was a prospective study from June 2006 to October 2008. The study included 48 patients who underwent Dynamic Hip Screw and Cannulated Cancellous Screw fixation for fracture neck of femur.
Results: This study evaluated Post reduction Pauwel’s angle for both types of fixation. Data analysis showed that with rise in Post reduction Pauwel’s angle, union rate decreases in both types of fixation.
Conclusion: Post reduction Pauwel’s angle is a good guide to know the stability of fractures and decrease in this angle corrects shearing instability of the fracture site. This study gives an indication that with a vertical fracture line, a valgus osteotomy might help in decreasing the incidence of non union.
Downloads
Download data is not yet available.
References
1. Christodouliou NA, Dretakin EK. Significance of muscular disturbances in the localization of fracture of the proximal femur. Clin Orthop Relat Res. 1984 Jul-Aug;(187):215-7.
2. Robinson CM, Court –Brown CM ,McQueen MM, Christie J. Hip fractures in adult younger than 50 years of age : Epidemiology and Result. Clin Orthop Relat Res.1995Mar;(312 ):238-46.ClinOrthopRelat Res. 1995 Mar;(312):238-46. [PubMed]
3. Askin SR, Bryan R. Femoral neck fractures in young adults. Clin Orthop Relat Res. 1976 Jan-Feb;(114):259-64. [PubMed]
4. Protzman RR, Burkhalter WE. Femoral neck fractures in young adults. J Bone Joint Surg Am. 1976 Jul;58(5):689-95. [PubMed]
5. Zetterberg CH, Elmerson S, Anderson GB. Epidemiology of hip fractures in Gotenberg, Sweden,1940-1983. Clin Orthop Relat Res. 1984 Dec;(191):43-52. [PubMed]
6. Pauwel F. (1935) Der schenkelhalsbrucheinmechanisches problem. Z OrthopIhre Grenzgeb,63, 1-135.
7. Ambroise Pare : Quoted in J.B.J.S; 1962:44-A:2.
8. Lee YS, Chen SH, Tsuang YH, Huang HL, Lo TY, Huang CR(2008): Internal fixation of undisplaced femoral neck fractures in the elderly: A retrospective comparison of fixation methods. The Journal of Trauma :injury,infection,and critical care : J Trauma 2008 Jan : 64(1): 155-62.
9. Jewell DP. Gheduzzi S, Mitchell MS, Miles AW(2008):Locking plates increases the strength of dynamic hip screw. Injury.2008 Feb;39(2):209-12. Epub 2007 Sep 18. [PubMed]
10. Massic WK. Fracture of the hip . J Bone Joint Surg Am. 1964 Apr;46:658-90. [PubMed]
11. Zolczer L, Kazár G, Manninger J, Nagy E. Fracture of the femoral neck in adolescence. Injury. 1972 Aug;4(1):41-6. [PubMed]
12. Kalra M1, Anand S. Valgus intertrochanteric osteotomy for neglected femoral neck fractures in young adults. Int Orthop. 2001;25(6):363-6. [PubMed]
13. Dedrick DK, Mackenzie JR, Burney RE. Complication of femoral neck fracture in young adults. J Trauma. 1986 Oct;26(10):932-7. [PubMed]
14. Zetterberg CH, Irstam L, Andersson GB. Femoral neck fractures in young adults. Acta Orthop Scand. 1982 Jun;53(3):427-35. [PubMed]
15. Swiontkowski MF, Winquist RA, Hansen ST Jr. Fractures of the femoral neck in patients between the ages of twelve and fourty nine years. J Bone Joint Surg Am. 1984 Jul;66(6):837-46. [PubMed]
16. Kofoed H. Femoral neck fractures in young adults. Injury. 1982 Sep;14(2):146-50. [PubMed]
17. Shih CH, Wang KC. Femoral neck fractures. Clin Orthop Relat Res. 1991 Oct;(271):195-200. [PubMed]
18. Lee CH, Huang GS, Chao KH, Jean JL. Surgical treatment of displaced stress fracture of the femoral neck in military recruits: A report of 42 cases. Arch Orthop Trauma Surg. 2003 Dec;123(10):527-33. Epub 2003 Sep 2. [PubMed]
19. Visuri T, Vara A, Meurman KO. Displaced stress fractures of the femoral neck in young male adults. A report of twelve operation cases. J Trauma. 1988 Nov;28(11):1562-9. [PubMed]
20. Haidukewych GJ, Rothwell WS, Jacofsky DJ, Torchia ME, Berry DJ.. Operative treatment of femoral neck fractures in patients between the ages of fifteen and fifty years. J Bone Joint Surg Am. 2004 Aug;86-A(8):1711-6. [PubMed]
21. Upadhyay A, Jain P, Mishra P. Maini L, Gautam VK, Dhaon BK. Delayed internal fixation of fractures of the neck of the femur in young adults. J Bone Joint Surg Br. 2004 Sep;86(7):1035-40. [PubMed]
22. Tooke SM, Favero KJ. Femoral neck fractures in skeletally mature patients, fifty years old or less. J Bone Joint Surg Am. 1985 Oct;67(8):1255-60. [PubMed]
23. Gautam VK, Anand S, Dhaon BK. Management of displaced femoral neck fractures in young adults ( a group at risk ) Injury. 1998 Apr;29(3):215-8. [PubMed]
24. Raaymakers EL. Fractures of femoral neck: A review and personal statement. Acta Chir Orthop Traumatol Cech. 2006;73(1):45-59. [PubMed]
25. Dickson JA. The unsolved fractures of protest against defeatism. J Bone Joint Surg Am. 1953 Oct;35-A(4):805-22. [PubMed]
26. Grewal KS. Fracture neck of femur. Kini Memorial Oration: Annual Conference of Association of Surgeons of India, Jaipur 1959.
27. Whitmann R: A new treatment for fracture of the femoral neck . Med. Rec.1904;65:441.
28. Leadbetter GW. A treatment of fracture neck of the femur. Clin Orthop Relat Res. 2002 Jun;(399):4-8. [PubMed]
29. Tengre and J. Kjellander ; Antibiotic prophylaxis in operation on trochanteric femoral fractures; Scan J Prim health care Sep 2002 :20(3);188-92.
30. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment my mold arthroplasty .An end result study using a new method of result evaluation . J Bone Joint Surg Am. 1969 Jun;51(4):737-55.
31. Asnis SE, Sgaglione LW (1994): Intracapsular fractures of the femoral neck. Results of cannulated screw fixation. J Bone Joint Surg Am 1994;76(12);1793-803. [PubMed]
32. Husby T, Alho A, Ronningen H. Stabilty of femoral neck osteosynthesis.Comparison of fixation methods in cadavers. Acta Orthop Scand. 1989 Jun;60(3):299-302. [PubMed]
33. Selvan VT, Oakey MJ, Rangen A, Al-Lami MK (2004): Optimum configuration of cannulated hip screws for the fixation of intrcapsular hip fractures : a biomechanical study. Injury. 2004 Feb;35(2):136-41. [PubMed]
34. Krastman P, van den Bent RP, Krijnen P, Schipper IB. Two cannulated hip screws for femoral neck fractures ; treatment of choice or asking for trouble. Arch Orthop Trauma Surg. 2006 Jul;126(5):297-303. Epub 2006 Apr 21. [PubMed]
35. Hulth A. The inclination of the fracture surface and its relation to the result of healing in femoral neck fractures. Acta Chir Scand. 1961 May;121:309-14. [PubMed]
36. Boyd HB, Salvatore JE, Acute fractures of the femoral neck: internal fixation or prosthesis? J Bone Joint Surg Am. 1964 Jul;46:1066-8. [PubMed]
37. Eklund J. and Eriksson F. Fractures of the femoral neck :with special regard to the treatment and prognosis of stable abduction fractures. Acta Chir Scand. 1964 Apr;127:315-37. [PubMed]
38. Frank Liporce, Robert Gaines, Cory Collinger, George J, Haidukewych . Results of internal fixation of pauwel’s type -3 vertical femoral neck fractures. J Bone Joint Surg Am. 2008 Aug;90(8):1654-9. doi: 10.2106/JBJS.G.01353.
39. Majernícek M, Dungl P, Kolman J, Malkus T, Vaculík J. Osteosynthesis of intracapsular femoral neck fractures by dynamic hip screw fixation. Acta Chir Orthop Traumatol Cech. 2009 Aug;76(4):319-25.
2. Robinson CM, Court –Brown CM ,McQueen MM, Christie J. Hip fractures in adult younger than 50 years of age : Epidemiology and Result. Clin Orthop Relat Res.1995Mar;(312 ):238-46.ClinOrthopRelat Res. 1995 Mar;(312):238-46. [PubMed]
3. Askin SR, Bryan R. Femoral neck fractures in young adults. Clin Orthop Relat Res. 1976 Jan-Feb;(114):259-64. [PubMed]
4. Protzman RR, Burkhalter WE. Femoral neck fractures in young adults. J Bone Joint Surg Am. 1976 Jul;58(5):689-95. [PubMed]
5. Zetterberg CH, Elmerson S, Anderson GB. Epidemiology of hip fractures in Gotenberg, Sweden,1940-1983. Clin Orthop Relat Res. 1984 Dec;(191):43-52. [PubMed]
6. Pauwel F. (1935) Der schenkelhalsbrucheinmechanisches problem. Z OrthopIhre Grenzgeb,63, 1-135.
7. Ambroise Pare : Quoted in J.B.J.S; 1962:44-A:2.
8. Lee YS, Chen SH, Tsuang YH, Huang HL, Lo TY, Huang CR(2008): Internal fixation of undisplaced femoral neck fractures in the elderly: A retrospective comparison of fixation methods. The Journal of Trauma :injury,infection,and critical care : J Trauma 2008 Jan : 64(1): 155-62.
9. Jewell DP. Gheduzzi S, Mitchell MS, Miles AW(2008):Locking plates increases the strength of dynamic hip screw. Injury.2008 Feb;39(2):209-12. Epub 2007 Sep 18. [PubMed]
10. Massic WK. Fracture of the hip . J Bone Joint Surg Am. 1964 Apr;46:658-90. [PubMed]
11. Zolczer L, Kazár G, Manninger J, Nagy E. Fracture of the femoral neck in adolescence. Injury. 1972 Aug;4(1):41-6. [PubMed]
12. Kalra M1, Anand S. Valgus intertrochanteric osteotomy for neglected femoral neck fractures in young adults. Int Orthop. 2001;25(6):363-6. [PubMed]
13. Dedrick DK, Mackenzie JR, Burney RE. Complication of femoral neck fracture in young adults. J Trauma. 1986 Oct;26(10):932-7. [PubMed]
14. Zetterberg CH, Irstam L, Andersson GB. Femoral neck fractures in young adults. Acta Orthop Scand. 1982 Jun;53(3):427-35. [PubMed]
15. Swiontkowski MF, Winquist RA, Hansen ST Jr. Fractures of the femoral neck in patients between the ages of twelve and fourty nine years. J Bone Joint Surg Am. 1984 Jul;66(6):837-46. [PubMed]
16. Kofoed H. Femoral neck fractures in young adults. Injury. 1982 Sep;14(2):146-50. [PubMed]
17. Shih CH, Wang KC. Femoral neck fractures. Clin Orthop Relat Res. 1991 Oct;(271):195-200. [PubMed]
18. Lee CH, Huang GS, Chao KH, Jean JL. Surgical treatment of displaced stress fracture of the femoral neck in military recruits: A report of 42 cases. Arch Orthop Trauma Surg. 2003 Dec;123(10):527-33. Epub 2003 Sep 2. [PubMed]
19. Visuri T, Vara A, Meurman KO. Displaced stress fractures of the femoral neck in young male adults. A report of twelve operation cases. J Trauma. 1988 Nov;28(11):1562-9. [PubMed]
20. Haidukewych GJ, Rothwell WS, Jacofsky DJ, Torchia ME, Berry DJ.. Operative treatment of femoral neck fractures in patients between the ages of fifteen and fifty years. J Bone Joint Surg Am. 2004 Aug;86-A(8):1711-6. [PubMed]
21. Upadhyay A, Jain P, Mishra P. Maini L, Gautam VK, Dhaon BK. Delayed internal fixation of fractures of the neck of the femur in young adults. J Bone Joint Surg Br. 2004 Sep;86(7):1035-40. [PubMed]
22. Tooke SM, Favero KJ. Femoral neck fractures in skeletally mature patients, fifty years old or less. J Bone Joint Surg Am. 1985 Oct;67(8):1255-60. [PubMed]
23. Gautam VK, Anand S, Dhaon BK. Management of displaced femoral neck fractures in young adults ( a group at risk ) Injury. 1998 Apr;29(3):215-8. [PubMed]
24. Raaymakers EL. Fractures of femoral neck: A review and personal statement. Acta Chir Orthop Traumatol Cech. 2006;73(1):45-59. [PubMed]
25. Dickson JA. The unsolved fractures of protest against defeatism. J Bone Joint Surg Am. 1953 Oct;35-A(4):805-22. [PubMed]
26. Grewal KS. Fracture neck of femur. Kini Memorial Oration: Annual Conference of Association of Surgeons of India, Jaipur 1959.
27. Whitmann R: A new treatment for fracture of the femoral neck . Med. Rec.1904;65:441.
28. Leadbetter GW. A treatment of fracture neck of the femur. Clin Orthop Relat Res. 2002 Jun;(399):4-8. [PubMed]
29. Tengre and J. Kjellander ; Antibiotic prophylaxis in operation on trochanteric femoral fractures; Scan J Prim health care Sep 2002 :20(3);188-92.
30. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment my mold arthroplasty .An end result study using a new method of result evaluation . J Bone Joint Surg Am. 1969 Jun;51(4):737-55.
31. Asnis SE, Sgaglione LW (1994): Intracapsular fractures of the femoral neck. Results of cannulated screw fixation. J Bone Joint Surg Am 1994;76(12);1793-803. [PubMed]
32. Husby T, Alho A, Ronningen H. Stabilty of femoral neck osteosynthesis.Comparison of fixation methods in cadavers. Acta Orthop Scand. 1989 Jun;60(3):299-302. [PubMed]
33. Selvan VT, Oakey MJ, Rangen A, Al-Lami MK (2004): Optimum configuration of cannulated hip screws for the fixation of intrcapsular hip fractures : a biomechanical study. Injury. 2004 Feb;35(2):136-41. [PubMed]
34. Krastman P, van den Bent RP, Krijnen P, Schipper IB. Two cannulated hip screws for femoral neck fractures ; treatment of choice or asking for trouble. Arch Orthop Trauma Surg. 2006 Jul;126(5):297-303. Epub 2006 Apr 21. [PubMed]
35. Hulth A. The inclination of the fracture surface and its relation to the result of healing in femoral neck fractures. Acta Chir Scand. 1961 May;121:309-14. [PubMed]
36. Boyd HB, Salvatore JE, Acute fractures of the femoral neck: internal fixation or prosthesis? J Bone Joint Surg Am. 1964 Jul;46:1066-8. [PubMed]
37. Eklund J. and Eriksson F. Fractures of the femoral neck :with special regard to the treatment and prognosis of stable abduction fractures. Acta Chir Scand. 1964 Apr;127:315-37. [PubMed]
38. Frank Liporce, Robert Gaines, Cory Collinger, George J, Haidukewych . Results of internal fixation of pauwel’s type -3 vertical femoral neck fractures. J Bone Joint Surg Am. 2008 Aug;90(8):1654-9. doi: 10.2106/JBJS.G.01353.
39. Majernícek M, Dungl P, Kolman J, Malkus T, Vaculík J. Osteosynthesis of intracapsular femoral neck fractures by dynamic hip screw fixation. Acta Chir Orthop Traumatol Cech. 2009 Aug;76(4):319-25.
CITATION
DOI: 10.17511/ijmrr.2015.i6.129
Published: 2015-07-31
How to Cite
1.
Ganvir A, Sirsikar A, Gupta S. Outcome analysis of post reduction pauwels angle in fracture neck of femur treated with dynamic hip screw or 6.5 mm cancellous cannulated screw fixation. Int J Med Res Rev [Internet]. 2015Jul.31 [cited 2024Nov.8];3(6):648-54. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/296
Issue
Section
Original Article
OAI - Open Archives Initiative
