Javdan Mohammad, Bahadori Mehran, Hosseini Alireza
Department of Orthopedics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2013 Mar 6;2:14. doi: 10.4103/2277-9175.107960. Print 2013.
There is conflict of interest in the treatment of intracapsular femoral neck fractures and the outcomes. The aim of this study was evaluation the treatment outcomes of closed and open reduction and internal fixation with screw in 18-50-year-old patients.
This clinical randomized study was conducted in Ayatollah Kashani Center in Isfahan from Nov 2010 to Nov 2011. In 42 patients selected in a randomized manner, fractures were reduced by closed reduction or open if necessary and C-ARM was controlled in AP and lateral plans. Movement range and femur pain severity were evaluated according to Visual analogue Scale (VAS) score at 3 and 6 months after surgery. Data were analyzed by SPSS 18. Chi-square, t-test, one-way analysis of variance (ANOVA), and descriptive statistics such as frequency distribution, mean, and mean deviation were used.
Forty-two patients with femoral neck fracture were treated by open [31 patients (73.8%)] or closed reduction [11 patients (26.2%)] and also osteosynthesis. Their mean age was 47.3 ± 9.8 years; 29 of them were males and 13 were females. Twelve patients had bad range of motion (ROM) (28.6%), 16 had intermediate ROM (38%), and 14 had good ROM (33.4%). After 6 months, 12 patients (28.6%) had bad ROM, 10 (23.8%) had intermediate ROM, and 20 (47.6%) had good ROM. There were 11 cases of non-union (35.5%) in the open reduction group and 4 in the closed group.
This study showed that femoral neck fracture is associated with several complications, especially if open reduction was necessary. So, the surgical method and necessary equipments such as radiolucent bed, C-ARM machine, and implant cannulated screw set should be considered.
股骨颈囊内骨折的治疗及其结果存在利益冲突。本研究的目的是评估18至50岁患者采用闭合复位和切开复位螺钉内固定的治疗效果。
本临床随机研究于2010年11月至2011年11月在伊斯法罕的阿亚图拉·卡沙尼中心进行。在随机选择的42例患者中,骨折通过闭合复位或必要时切开复位,并在前后位和侧位平面用C形臂进行控制。根据视觉模拟量表(VAS)评分在术后3个月和6个月评估活动范围和股骨疼痛严重程度。数据用SPSS 18进行分析。使用卡方检验、t检验、单因素方差分析(ANOVA)以及频率分布、均值和平均偏差等描述性统计方法。
42例股骨颈骨折患者接受了切开复位[31例(73.8%)]或闭合复位[11例(26.2%)]及内固定治疗。他们的平均年龄为47.3±9.8岁;其中29例为男性,13例为女性。12例患者活动范围(ROM)较差(28.6%),16例ROM中等(38%),14例ROM良好(33.4%)。6个月后,12例患者(28.6%)ROM较差,10例(23.8%)ROM中等,20例(47.6%)ROM良好。切开复位组有11例骨不连(35.5%),闭合复位组有4例。
本研究表明,股骨颈骨折与多种并发症相关,尤其是在需要切开复位时。因此,应考虑手术方法以及必要的设备,如透光床、C形臂机和空心螺钉植入套件。