Thein Ran, Herman Amir, Kedem Paz, Chechik Aharon, Shazar Nachshon
*Department of Orthopedic Surgery; and †Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Orthop Trauma. 2014 Feb;28(2):70-6. doi: 10.1097/BOT.0b013e3182a225fa.
The purpose of this study was to compare the postoperative radiologic and clinical outcomes of telescopic femur neck screws and small locking plate device (Targon FN) (group 1) with multiple cancellous screws (group 2) for displaced intracapsular femoral neck fractures.
Comparison of a prospective collected data to a historical control group (retrospective).
One community teaching hospital.
Seventy-eight patients (group 1, 31; group 2, 47) underwent reduction and internal fixation of displaced intracapsular femoral neck fractures with either Targon FN device or multiple cancellous screws from March 2000 to July 2010. Their mean age was 53.7 years (SD: 16.4), and the mean follow-up period was 28.6 months.
Treatment failure was considered to be either a nonunion, osteonecrosis, or revision surgery of any type. Treatment was regarded as successful in patients who did not show failure and had at least 1-year follow-up.
One patient in group 1 (3.2%) and 22 (46.8%) in group 2 had a nonunion (P = 0.0001). Four (12.9%) group 1 patients and 16 (34.0%) group 2 patients underwent revision surgery (P = 0.036). Four (12.9%) patients in group 1 and 4 (8.5%) group 2 patients had osteonecrosis of the femoral head (P = 0.531). Multivariate logistic regression showed that internal fixation by the fixed-angle fixation device decreased the odds ratio for overall complication by a factor of 0.23, for example, by 77% (P = 0.018).
Performing internal fixation by a fixed-angle fixation device decreased nonunion rates and revision rates. It did not affect the rate of osteonecrosis.
Therapeutic level III. See instructions for authors for a complete description of levels of evidence.
本研究旨在比较 telescopic 股骨颈螺钉与小型锁定钢板装置（Targon FN）（第 1 组）和多枚松质骨螺钉（第 2 组）治疗移位型囊内股骨颈骨折的术后影像学及临床疗效。
将前瞻性收集的数据与历史对照组（回顾性）进行比较。
一家社区教学医院。
2000 年 3 月至 2010 年 7 月期间，78 例患者（第 1 组 31 例；第 2 组 47 例）接受了 Targon FN 装置或多枚松质骨螺钉治疗移位型囊内股骨颈骨折并进行复位和内固定。他们的平均年龄为 53.7 岁（标准差：16.4），平均随访时间为 28.6 个月。
治疗失败被定义为骨不连、骨坏死或任何类型的翻修手术。未出现失败且至少随访 1 年的患者视为治疗成功。
第 1 组 1 例患者（3.2%）和第 2 组 22 例患者（46.8%）发生骨不连（P = 0.0001）。第 1 组 4 例（12.9%）患者和第 2 组 16 例（34.0%）患者接受了翻修手术（P = 0.036）。第 1 组 4 例（12.9%）患者和第 2 组 4 例（8.5%）患者发生股骨头坏死（P = 0.531）。多因素逻辑回归显示，使用角稳定固定装置进行内固定使总体并发症的比值比降低了 0.23 倍，即降低了 77%（P = 0.018）。
使用角稳定固定装置进行内固定可降低骨不连率和翻修率。它不影响骨坏死率。
治疗性 III 级。有关证据级别的完整描述，请参阅作者指南。
