Treatment of old femoral neck fractures in young adults with a medial buttress plate combined with three cannulated screws and iliac autograft: Surgical technique and preliminary results.

OBJECTIVES: Whether the application of MBP plus cannulated screws works for old femoral neck fractures(OFNF) is unknown.The purpose of this study is to present a case series of OFNF in young adults using calcar buttress plate and three cannulated screws with autologous iliac bone grafts.

METHODS: We conducted a retrospective study of eleven young patients (6 males and 5 females) with femoral neck fractures who were treated with open reduction and internal fixation at a single center between 2013 and 2021. The subjects had trauma-to-surgery intervals longer than 3 weeks and all were fixed with a calcar buttress plate combined with three cannulated screws, which were supplemented by autologous iliac bone grafts.

RESULTS: All eleven cases achieved radiological union under the surgery technique, which occurred on average at 4.46±1.29 months after surgery. Complications included femoral neck shortening in all cases, heterotopic ossification in three cases, and osteonecrosis of the femoral head in two cases. One patient with osteonecrosis of the femoral head received total hip arthroplasty. In follow-ups of 24-52 months, the median Harris hip score was 81.64±15.39.

CONCLUSIONS: The medial buttress plate in combination with three cannulated screws and iliac autograft may be a good choice for treating old femoral neck fractures in young adults. Level of evidence IV, case series.