Schwarz N
Unfallkrankenhaus, Klagenfurt, Osterreich.
Z Orthop Unfall. 2010 Mar;148(2):191-7. doi: 10.1055/s-0029-1240588.
The aim of this study was to evaluate the validity of Pauwels' classification of femoral neck fractures.
A study of literature was performed.
It has never been proven that the inclination of the fracture plane has a prognostic relevance. A number of papers prove the contrary, there are no publications where Pauwels' classification has been used successfully in selecting treatment modalities. Pauwels' theory of fracture inclination angle has not been transferred into clinical practice. This discrepancy probably goes back to the fact that the angle cannot be determined preoperatively, that in the majority of femoral neck fractures the angle is within the range of 40 to 60 degrees, that the theoretical angle variations do practically not exist, and that the shearing forces are reduced to an unknown amount by friction resistance due to the uneven fracture plane. The mechanical laws of the pseudarthrosis of the femoral neck cannot be extrapolated to acute fractures.
The theory of Pauwels has apparently no clinical relevance for the majority of acute fractures, except for the rare transcervical fractures, and should not be considered any longer as a classification of acute femoral neck fractures due to the lack of prognostic and therapeutic relevance.
本研究旨在评估 Pauwels 股骨颈骨折分类法的有效性。
进行文献研究。
骨折平面的倾斜度与预后的相关性从未得到证实。许多论文证明了相反的情况，没有出版物表明 Pauwels 分类法在选择治疗方式方面成功应用。Pauwels 的骨折倾斜角理论尚未转化为临床实践。这种差异可能源于以下事实：该角度无法在术前确定，大多数股骨颈骨折的角度在 40 至 60 度范围内，理论上的角度变化实际上并不存在，并且由于骨折平面不平整，摩擦力会将剪切力减小到未知程度。股骨颈假关节的力学定律不能外推至急性骨折。
除了罕见的经颈骨折外，Pauwels 理论对大多数急性骨折显然没有临床相关性，由于缺乏预后和治疗相关性，不应再将其视为急性股骨颈骨折的分类方法。
