Pauwels Classification of Femoral Neck Fractures
Classifies femoral neck fractures by angle of fracture line from horizontal (Pauwels 1935). Higher angle = more shear stress, worse prognosis, more likely to fail with screws alone.
Score interpretation
→ Internal fixation (3 cannulated screws) preferred in young patients; hemiarthroplasty in elderly per NICE CG124. Low non-union risk.
→ Internal fixation with 3 screws or sliding hip screw in young; arthroplasty in elderly or displaced. Discuss outcomes carefully.
→ High shear forces — high non-union and AVN risk. In young (<55): fixed-angle implant (sliding hip screw + anti-rotation screw, or femoral neck system) within 24 h; consider osteotomy if non-union. In elderly: total hip arthroplasty (NICE CG124).
Interpretation bands for the Pauwels. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Cetuximab · Anti-EGFR Monoclonal Antibody — Head and Neck Cancer
- Cisplatin · Platinum Chemotherapy — Head and Neck Cancer
- Methotrexate · Chemotherapy / Immunosuppressant — Head and Neck / Granulomatosis
- Pembrolizumab (Head and Neck SCC) · PD-1 Inhibitor
- Nivolumab (Head and Neck SCC) · PD-1 Inhibitor
- Co-amoxiclav (Open Fracture Antibiotic Prophylaxis) · Beta-lactam / Beta-lactamase Inhibitor Combination
- Hip Fracture Management · NICE CG124 / BOA 2020
- Distal Radius Fracture · BOA / NICE
- Ankle Fracture Management · BOA / Lauge-Hansen classification
- Metastatic Spinal Cord Compression · NICE CG75 2020
- Open Fracture Management · BOA/BAPRAS 2017
- OrthoPath: Upper Limb ED Triage · OrthoPath ED Tool — ReviseMRCEM.com
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.