Lin Dasheng, Lian Kejian, Ding Zhenqi, Zhai Wenliang, Hong Jiayuan
Department of Orthopaedic Surgery, the Affiliated Southeast Hospital of Xiamen University, Orthopaedic Trauma Center of PLA, Zhangzhou, China.
Orthopedics. 2012 Jan 16;35(1):e1-5. doi: 10.3928/01477447-20111122-08.
The purpose of this study was to evaluate the efficacy and safety of the proximal femoral locking plate with cannulated screws for the treatment of femoral neck fractures. A prospective study was performed in 41 patients with femoral neck fractures treated with a proximal femoral locking plate with cannulated screws between January 2005 and December 2008. Twenty-five men and 16 women had a mean age of 47 years (range, 21-65 years). The time from injury to surgery ranged from 2 hours to 7 days. Three patients had a Garden type I fracture, 9 a type II, 18 a type III and 11 a type IV. Operative time, intraoperative blood loss, fracture healing time, Harris Hip Score for hip function, and complications were recorded to evaluate treatment effects.Mean operative time was 63.6 minutes (range, 40-90 minutes), with mean intraoperative blood loss of 84.2 mL (range, 50-200 mL). Mean time to union was 15.5 weeks (range, 12-36 weeks). Two patients (Garden type III and type IV) did not achieve union, and 4 patients (1 Garden type III and 3 type IV) had avascular necrosis of the femoral head. In patients with nonunion, 1 (Garden type III) underwent intertrochanteric osteotomy, and the other underwent total hip replacement (THR). In patients with avascular necrosis, 2 required THR and the others (1 Garden type III) required no further surgery. Twenty-six (63%) patients had excellent results, 8 (20%) had good results, 3 (7%) had moderate results, and 4 (10%) had poor results. These findings suggest that the proximal femoral locking plate with cannulated screws for the treatment of femoral neck fractures is effective and results in fewer complications, especially for Garden type I, II, and III fractures.
本研究的目的是评估带空心螺钉的股骨近端锁定钢板治疗股骨颈骨折的疗效和安全性。对2005年1月至2008年12月间采用带空心螺钉的股骨近端锁定钢板治疗的41例股骨颈骨折患者进行了一项前瞻性研究。其中男性25例，女性16例，平均年龄47岁（范围21 - 65岁）。受伤至手术的时间为2小时至7天。3例为Garden I型骨折，9例为II型，18例为III型，11例为IV型。记录手术时间、术中出血量、骨折愈合时间、髋关节功能的Harris髋关节评分以及并发症情况以评估治疗效果。平均手术时间为63.6分钟（范围40 - 90分钟），平均术中出血量为84.2毫升（范围50 - 200毫升）。平均愈合时间为15.5周（范围12 - 36周）。2例（Garden III型和IV型）未达到骨折愈合，4例（1例Garden III型和3例IV型）发生股骨头缺血性坏死。对于骨折不愈合的患者，1例（Garden III型）接受了转子间截骨术，另1例接受了全髋关节置换术（THR）。对于股骨头缺血性坏死的患者，2例需要进行THR，其他患者（1例Garden III型）无需进一步手术。26例（63%）患者效果极佳，8例（20%）效果良好，3例（7%）效果中等，4例（10%）效果较差。这些结果表明，带空心螺钉的股骨近端锁定钢板治疗股骨颈骨折是有效的，且并发症较少，尤其是对于Garden I型、II型和III型骨折。
