Kalsbeek J H, van Walsum A D P, Vroemen J P A M, Janzing H M J, Winkelhorst J T, Bertelink B P, Roerdink W H
Department of Trauma Surgery, Deventer Ziekenhuis, Nico Bolkesteinlaan 75, 7416 SE Deventer, The Netherlands.
Department of Trauma Surgery, Medisch Spectrum Twente, Koningsplein 1, 7512 KZ Enschede, The Netherlands.
Bone Joint J. 2018 Apr 1;100-B(4):443-449. doi: 10.1302/0301-620X.100B4.BJJ-2016-1098.R3.
The objective of this study was to investigate bone healing after internal fixation of displaced femoral neck fractures (FNFs) with the Dynamic Locking Blade Plate (DLBP) in a young patient population treated by various orthopaedic (trauma) surgeons.
We present a multicentre prospective case series with a follow-up of one year. All patients aged ≤ 60 years with a displaced FNF treated with the DLBP between 1st August 2010 and December 2014 were included. Patients with pathological fractures, concomitant fractures of the lower limb, symptomatic arthritis, local infection or inflammation, inadequate local tissue coverage, or any mental or neuromuscular disorder were excluded. Primary outcome measure was failure in fracture healing due to nonunion, avascular necrosis, or implant failure requiring revision surgery.
In total, 106 consecutive patients (mean age 52 years, range 23 to 60; 46% (49/106) female) were included. The failure rate was 14 of 106 patients (13.2%, 95% confidence interval (CI) 7.1 to 19.9). Avascular necrosis occurred in 11 patients (10.4%), nonunion in six (5.6%), and loss of fixation in two (1.9%).
The rate of fracture healing after DLBP fixation of displaced femoral neck fracture in young patients is promising and warrants further investigation by a randomized trial to compare the performance against other contemporary methods of fixation. Cite this article: Bone Joint J 2018;100-B:443-9.
本研究的目的是调查在不同骨科（创伤）外科医生治疗的年轻患者群体中，使用动力锁定刀片钢板（DLBP）内固定移位型股骨颈骨折（FNF）后的骨愈合情况。
我们呈现了一个随访一年的多中心前瞻性病例系列。纳入了2010年8月1日至2014年12月期间所有年龄≤60岁、采用DLBP治疗的移位型FNF患者。排除病理性骨折、下肢合并骨折、症状性关节炎、局部感染或炎症、局部组织覆盖不足或任何精神或神经肌肉疾病患者。主要结局指标是因骨不连、缺血性坏死或需要翻修手术的植入物失败导致的骨折愈合失败。
总共纳入了106例连续患者（平均年龄52岁，范围23至60岁；46%（49/106）为女性）。失败率为106例患者中的14例（13.2%，95%置信区间（CI）7.1至19.9）。11例患者（10.4%）发生缺血性坏死，6例（5.6%）发生骨不连，2例（1.9%）发生内固定失败。
年轻患者移位型股骨颈骨折采用DLBP固定后的骨折愈合率前景良好，值得通过随机试验进一步研究，以比较其与其他当代固定方法的性能。引用本文：《骨与关节杂志》2018年；100-B：443 - 9。
