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Treatment of femoral neck nonunion with a new fixation construct through the Watson-Jones approach

OBJECTIVE: The aim of the study is to explore the clinical effect of a dynamic condylar screw (DCS) system, medial anatomical buttress plate (MABP), and autogenous iliac bone graft through the Watson-Jones approach in the treatment of femoral neck nonunion. METHODS: This prospective study included 1...

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Autores principales: Chen, Hua, Li, Jia, Chang, Zuhao, Liang, Xiangdang, Tang, Peifu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Chinese Speaking Orthopaedic Society 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6896481/
https://www.ncbi.nlm.nih.gov/pubmed/31844620
http://dx.doi.org/10.1016/j.jot.2019.04.004
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author Chen, Hua
Li, Jia
Chang, Zuhao
Liang, Xiangdang
Tang, Peifu
author_facet Chen, Hua
Li, Jia
Chang, Zuhao
Liang, Xiangdang
Tang, Peifu
author_sort Chen, Hua
collection PubMed
description OBJECTIVE: The aim of the study is to explore the clinical effect of a dynamic condylar screw (DCS) system, medial anatomical buttress plate (MABP), and autogenous iliac bone graft through the Watson-Jones approach in the treatment of femoral neck nonunion. METHODS: This prospective study included 15 patients (12 men and 3 women) with nonunion of femoral neck fracture, who were treated with the DCS and MABP with autogenous iliac bone graft through the Watson-Jones approach. The patients were followed up for an average of 16 months (range, 12–24 months). RESULTS: All patients achieved bone healing with an average fracture healing time of 3.4 months (2.8–4.6 months). The Harris score significantly increased from 30 ± 3.9 before the operation to 87.6 ± 7.9 at the last follow-up, and the visual analogue scale significantly decreased from 4 ± 1.3 before the operation to 1 ± 1.7 at the last follow-up. The average limb shortening was reduced from 1.8 cm (range, 0–3.1 cm) before the revision operation to 0.5 cm (range, 0.1–1.3 cm) after the last follow-up. The neck-shaft angle of the injured side was restored from an average of 118° (range, 108–139°) before the revision operation to an average of 132° (range, 127–144°) at the last follow-up. No collapse of the femoral head, wound infections, screw backout, screw or plate breakages, or nerve injury was found. CONCLUSION: TheDCS and MABP with autogenous iliac bone graft through the Watson-Jones approach is an effective option for the treatment of femoral neck nonunion or delayed healing. THE TRANSLATIONAL POTENTIAL OF THE ARTICLE: This article shows that the application of DCS and MABP provides a rigid fixation at the fracture site to promote bone graft integration and bone union. This new kind of technique could be one option of Hip conservation procedures, just special for young patients with femoral neck nonunion.
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spelling pubmed-68964812019-12-16 Treatment of femoral neck nonunion with a new fixation construct through the Watson-Jones approach Chen, Hua Li, Jia Chang, Zuhao Liang, Xiangdang Tang, Peifu J Orthop Translat Original Article OBJECTIVE: The aim of the study is to explore the clinical effect of a dynamic condylar screw (DCS) system, medial anatomical buttress plate (MABP), and autogenous iliac bone graft through the Watson-Jones approach in the treatment of femoral neck nonunion. METHODS: This prospective study included 15 patients (12 men and 3 women) with nonunion of femoral neck fracture, who were treated with the DCS and MABP with autogenous iliac bone graft through the Watson-Jones approach. The patients were followed up for an average of 16 months (range, 12–24 months). RESULTS: All patients achieved bone healing with an average fracture healing time of 3.4 months (2.8–4.6 months). The Harris score significantly increased from 30 ± 3.9 before the operation to 87.6 ± 7.9 at the last follow-up, and the visual analogue scale significantly decreased from 4 ± 1.3 before the operation to 1 ± 1.7 at the last follow-up. The average limb shortening was reduced from 1.8 cm (range, 0–3.1 cm) before the revision operation to 0.5 cm (range, 0.1–1.3 cm) after the last follow-up. The neck-shaft angle of the injured side was restored from an average of 118° (range, 108–139°) before the revision operation to an average of 132° (range, 127–144°) at the last follow-up. No collapse of the femoral head, wound infections, screw backout, screw or plate breakages, or nerve injury was found. CONCLUSION: TheDCS and MABP with autogenous iliac bone graft through the Watson-Jones approach is an effective option for the treatment of femoral neck nonunion or delayed healing. THE TRANSLATIONAL POTENTIAL OF THE ARTICLE: This article shows that the application of DCS and MABP provides a rigid fixation at the fracture site to promote bone graft integration and bone union. This new kind of technique could be one option of Hip conservation procedures, just special for young patients with femoral neck nonunion. Chinese Speaking Orthopaedic Society 2019-04-28 /pmc/articles/PMC6896481/ /pubmed/31844620 http://dx.doi.org/10.1016/j.jot.2019.04.004 Text en © 2019 Published by Elsevier (Singapore) Pte Ltd on behalf of Chinese Speaking Orthopaedic Society. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Chen, Hua
Li, Jia
Chang, Zuhao
Liang, Xiangdang
Tang, Peifu
Treatment of femoral neck nonunion with a new fixation construct through the Watson-Jones approach
title Treatment of femoral neck nonunion with a new fixation construct through the Watson-Jones approach
title_full Treatment of femoral neck nonunion with a new fixation construct through the Watson-Jones approach
title_fullStr Treatment of femoral neck nonunion with a new fixation construct through the Watson-Jones approach
title_full_unstemmed Treatment of femoral neck nonunion with a new fixation construct through the Watson-Jones approach
title_short Treatment of femoral neck nonunion with a new fixation construct through the Watson-Jones approach
title_sort treatment of femoral neck nonunion with a new fixation construct through the watson-jones approach
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6896481/
https://www.ncbi.nlm.nih.gov/pubmed/31844620
http://dx.doi.org/10.1016/j.jot.2019.04.004
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