Stiasny Jerzy, Dragan Szymon, Kulej Mirosław, Martynkiewicz Jacek, Płochowski Jerzy, Dragan Szymon Łukasz
Orthopaedics & Traumatologic Department, Hjörring Regional Hospital, Denmark.
Ortop Traumatol Rehabil. 2008 Jul-Aug;10(4):350-61.
Femoral neck fractures are among the most frequent and the most dangerous types of musculoskeletal injuries in the elderly population. There is general agreement that because of the morphology of the fracture, internal fixation is the treatment of choice irrespective of the degree of displacement. The optimal surgical treatment of femoral neck fractures remains controversial despite constant progress in the surgical management of such fractures and still remains a serious therapeutic problem. The goal of the present study was to compare the outcome in patients who underwent surgery of femoral neck fractures with AO screws; a compression screw and a side-plate; and a compression screw and a side-plate with an additional AO screw.
The study group included 112 patients who underwent surgery for femoral neck fracture with the use of AO screws; a compression screw and a side-plate; and compression screw and a side-plate with an additional AO screw, at the Orthopaedic Department at Vendsyssel Hospital, Hjörring, Northern Orthopaedic Division, Denmark, between 1 January 2004 and 31 December 2005. Garden's classification was used to classify femoral neck fractures. Implant position and fracture reduction were categorised according to recommendations by Tornkvist and Lindequist.
Irrespective of fracture morphology, compression screw and side-plate fixation provides better stabilisation to the bony fragments and improves early mobilisation in comparison with AO screws.
股骨颈骨折是老年人群中最常见且最危险的肌肉骨骼损伤类型之一。人们普遍认为,由于骨折的形态,无论移位程度如何,内固定都是首选治疗方法。尽管股骨颈骨折的手术治疗不断取得进展,但最佳手术治疗方法仍存在争议,并且仍然是一个严重的治疗难题。本研究的目的是比较接受股骨颈骨折AO螺钉手术的患者;一枚加压螺钉和一块侧板;以及一枚加压螺钉、一块侧板加一枚额外AO螺钉的患者的治疗结果。
研究组包括112例在2004年1月1日至2005年12月31日期间于丹麦北日德兰地区霍宁文德西塞尔医院骨科接受股骨颈骨折手术的患者,手术方式分别为使用AO螺钉;一枚加压螺钉和一块侧板;以及一枚加压螺钉、一块侧板加一枚额外AO螺钉。采用Garden分型对股骨颈骨折进行分类。根据Tornkvist和Lindequist的建议对植入物位置和骨折复位情况进行分类。
无论骨折形态如何,与AO螺钉相比,加压螺钉和侧板固定能为骨碎片提供更好的稳定性,并改善早期活动能力。