{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:34:42Z","timestamp":1788845682598,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T00:00:00Z","timestamp":1650499200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the outcomes of open reduction and internal fixation combined with medial buttress plate (MBP) and allograft bone\u2010assisted cannulated screw (CS) fixation for patients with unstable femoral neck fracture with comminuted posteromedial cortex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a retrospective study of patients operated on for unstable femoral neck fractures with comminuted posteromedial cortex from March 2016 to August 2020, the clinical and radiographic outcomes of 48 patients treated with CS\u2009+\u2009MBP were compared with the outcomes of 54 patients treated with CS only. All patients in the CS\u2009+\u2009MBP group were fixed by three CS and MBP (one\u2010third tubular plates or reconstructive plates) with bone allografts. The surgery\u2010related outcomes and complications were evaluated, including operative time, blood loss, union time, femoral head necrosis, femoral neck shortening, and other complications after the operation. The Harris score was evaluated at 12\u00a0months after the operation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients were followed up for 12\u201340\u00a0months. The average age of patients in the CS\u2010only group (54 cases, 22 females) and CS\u2009+\u2009MBP group (48 cases, 20 females) was 48.46\u2009\u00b1\u20097.26 and 48.73\u2009\u00b1\u20096.38\u2009years, respectively. More intraoperative blood loss was observed in the CS\u2009+\u2009MBP group than that of patients in CS\u2010only group (153.45\u2009\u00b1\u200964.27 <jats:italic>vs<\/jats:italic> 21.86\u2009\u00b1\u200918.19 ml, <jats:italic>t<\/jats:italic>\u00a0=\u00a04.058, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.015). The average operative time for patients in the CS\u2009+\u2009MBP group (75.35\u2009\u00b1\u200927.67\u00a0min) was almost double than that of patients in the CS\u2010only group (36.87\u2009\u00b1\u200915.39\u00a0min) (<jats:italic>t<\/jats:italic>\u00a0=\u00a02.455, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The Garden alignment index of patients treated by CS\u2009+\u2009MBP from type I to type IV was 79%, 19%, 2%, and 0%, respectively. On the contrary, they were 31%, 43%, 24% and 2% for those in the CS\u2010only group, respectively. The average healing times for the CS\u2010only and CS\u2009+\u2009MBP groups were 4.34\u2009\u00b1\u20091.46 and 3.65\u2009\u00b1\u20091.85\u00a0months (<jats:italic>t<\/jats:italic>\u00a0=\u00a01.650, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.102), respectively. Femoral neck shortening was better in the CS\u2009+\u2009MBP group (1.40\u2009\u00b1\u20091.73\u2009mm, 9\/19) than that in the CS\u2010only group (4.33\u2009\u00b1\u20093.32\u2009mm, 24\/44). Significantly higher hip function was found in the CS\u2009+\u2009MBP group (85.60\u2009\u00b1\u20094.36 <jats:italic>vs<\/jats:italic> 82.47\u2009\u00b1\u20096.33, <jats:italic>t<\/jats:italic>\u00a0=\u00a01.899, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.06). There was no statistical difference between femoral head necrosis (4% <jats:italic>vs<\/jats:italic> 11%, <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a01.695, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.193) and nonunion (6% <jats:italic>vs<\/jats:italic> 9%, <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.318, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.719).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For unstable femoral neck fractures with comminuted posteromedial cortex, additional MBP combined with bone allografts showed better reduction quality and neck length control than CS fixation only, with longer operative time and more blood loss.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13273","type":"journal-article","created":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T08:34:53Z","timestamp":1650530093000},"page":"911-918","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Medial Buttress Plate and Allograft Bone\u2010Assisted Cannulated Screw Fixation for Unstable Femoral Neck Fracture with Posteromedial Comminution: A Retrospective Controlled Study"],"prefix":"10.1111","volume":"14","author":[{"given":"Zhe\u2010yuan","family":"Huang","sequence":"first","affiliation":[{"name":"Nan Fang Hospital of Southern Medical University  Guangzhou China"},{"name":"Department of Orthopaedics, The 73st Group Army Hospital of PLA (Key Orthopaedic Specialties Specialties of Xiamen City 2015347)  Xiamen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010hui","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The 73st Group Army Hospital of PLA (Key Orthopaedic Specialties Specialties of Xiamen City 2015347)  Xiamen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi\u2010ping","family":"Huang","sequence":"additional","affiliation":[{"name":"Nan Fang Hospital of Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010bei","family":"Wang","sequence":"additional","affiliation":[{"name":"Nan Fang Hospital of Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gui\u2010cheng","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Anatomy Xiamen Medical College  Xiamen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan\u2010peng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The 73st Group Army Hospital of PLA (Key Orthopaedic Specialties Specialties of Xiamen City 2015347)  Xiamen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The 73st Group Army Hospital of PLA (Key Orthopaedic Specialties Specialties of Xiamen City 2015347)  Xiamen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The 73st Group Army Hospital of PLA (Key Orthopaedic Specialties Specialties of Xiamen City 2015347)  Xiamen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2910-9400","authenticated-orcid":false,"given":"Qing\u2010an","family":"Zhu","sequence":"additional","affiliation":[{"name":"Nan Fang Hospital of Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-199004030-00009"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199310000-00022"},{"key":"e_1_2_6_4_1","first-page":"238","article-title":"Hip fractures in adults younger than 50years of age. 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