Pauwel's angle

Pauwel's angle is a medical measurement used in the diagnosis and treatment of hip fractures. It is named after the Belgian orthopedic surgeon Ferdinand Pauwels, who first described it in 1935. The angle is formed by the intersection of the line of the fracture and the horizontal line of the femoral neck axis.

Definition

Pauwel's angle is defined as the angle between the line of the fracture and the horizontal line of the femoral neck axis. It is used to classify femoral neck fractures into three types: Type I (less than 30 degrees), Type II (30-50 degrees), and Type III (more than 50 degrees). The higher the Pauwel's angle, the higher the shear stress on the fracture, which can affect the healing process and the choice of treatment.

Clinical Significance

Pauwel's angle is used in the diagnosis and treatment of hip fractures. It helps to determine the severity of the fracture and the type of treatment required. A higher Pauwel's angle is associated with a higher risk of nonunion and avascular necrosis, due to the increased shear stress on the fracture. Therefore, fractures with a high Pauwel's angle may require more aggressive treatment, such as internal fixation with screws or a hip replacement.

Measurement

Pauwel's angle is measured on an anteroposterior (AP) radiograph of the hip. The line of the fracture is drawn, and then a horizontal line is drawn along the axis of the femoral neck. The angle between these two lines is the Pauwel's angle.

See Also

• Femoral neck fracture
• Garden's classification
• Hip replacement
• Internal fixation

References

1. Pauwels F. Der Schenkelhalsbruch, ein mechanisches Problem. Grundlagen des Heilungsvorganges Prognose und kausale Therapie. Stuttgart: Ferdinand Enke Verlag; 1935.
2. Garden RS. Low-angle fixation in fractures of the femoral neck. J Bone Joint Surg Br. 1961;43:647–663.

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