Gao Hongwei, Xing Deguo, Liu Zhonghao, Zheng Jiachun, Xiong Zhenggang, Gong Mingzhi, Liu Lan
Department of Trauma and Orthopedics.
Medical Department, The Second Hospital of Shandong University, Shandong Province, Peoples Republic of China.
Medicine (Baltimore). 2020 Feb;99(6):e18976. doi: 10.1097/MD.0000000000018976.
The risk of avascular necrosis (AVN) and nonunion after treatment of displaced femoral neck fractures is increased in patients aged <60 years. Therefore we established a new protocol for closed reduction and internal fixation (CRIF) using cannulated screws combined with bone morphogenetic protein 2 (BMP-2) composite materials to treat acute femoral neck fractures.This study enrolled 78 patients with acute femoral neck fractures between April 2014 and September 2016. We treated 46 patients with a mean age of 43.8 years in study group. These patients were treated by CRIF combined with BMP-2 composite materials. In control group, there were 32 patients with a mean age of 42.09 years. The patients were treated by CRIF without BMP-2. The duration between presentation and surgery, operative time, Harris score and complications were recorded.In study group, 43 patients were followed up with an average of 31.3 months. One patient suffered nonunion and three patients presented AVN. In control group, 28 patients were followed up with an average of 32.3 months, the rate of AVN and fracture nonunion were 25% (7/28) and 21.4% (6/28) respectively, significantly higher than those in study group (P < .05).Acute displaced femoral neck fractures can be treated with CRIF and BMP-2 composite materials in a minimally invasive manner. This technique was reproducible and had fewer complications.
年龄小于60岁的患者在治疗移位型股骨颈骨折后发生缺血性坏死（AVN）和骨不连的风险会增加。因此，我们制定了一种新的闭合复位内固定（CRIF）方案，使用空心螺钉结合骨形态发生蛋白2（BMP-2）复合材料来治疗急性股骨颈骨折。本研究纳入了2014年4月至2016年9月期间78例急性股骨颈骨折患者。研究组治疗了46例平均年龄为43.8岁的患者。这些患者采用CRIF联合BMP-2复合材料进行治疗。对照组有32例平均年龄为42.09岁的患者。这些患者采用不使用BMP-2的CRIF进行治疗。记录了就诊至手术的时间、手术时间、Harris评分和并发症情况。研究组43例患者获得随访，平均随访31.3个月。1例发生骨不连，3例出现AVN。对照组28例患者获得随访，平均随访32.3个月，AVN发生率和骨折不愈合率分别为25%（7/28）和21.4%（6/28），显著高于研究组（P<0.05）。急性移位型股骨颈骨折可以采用CRIF和BMP-2复合材料以微创方式进行治疗。该技术具有可重复性且并发症较少。
