Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Clin Orthop Surg. 2020 Jun;12(2):258-262. doi: 10.4055/cios19156. Epub 2020 May 14.
The mainstream surgery for valgus-impacted femoral neck fractures (FNFs) is closed reduction and internal fixation under fluoroscopy. However, femoral neck shortening and anterior femoroacetabular impingement are common complications in healed valgus-impacted FNFs after fixation. Some methods have been reported to prevent complications, but these techniques require the use of a transfixing guide wire that passes through the femoral head, which may cause articular cartilage damage. We introduce a simple reduction technique using one Steinmann pin (S-pin) for valgus-impacted FNFs without any interference of the femur head. A S-pin was placed percutaneously at the inferomedial margin of the fracture, and reduction was achieved by applying manual valgus force along the fracture line. By restoring the anatomical alignment, we confirmed the maximum contact area of the fracture and connection of the medial cortical buttress, so the risk of nonunion was also minimized.
对于外翻型股骨颈骨折（FNF），主流的手术方法是在透视下闭合复位内固定。然而，在固定后愈合的外翻型股骨颈骨折中，股骨颈缩短和前股骨髋臼撞击是常见的并发症。一些方法已经被报道可以预防这些并发症，但这些技术需要使用穿过股骨头的贯穿固定导丝，这可能会导致关节软骨损伤。我们介绍了一种使用一根斯氏针（S 针）的简单复位技术，用于治疗没有股骨头干扰的外翻型股骨颈骨折。一根 S 针经皮置于骨折的下内侧缘，通过沿骨折线施加手动外翻力来实现复位。通过恢复解剖对位，我们确认了骨折的最大接触面积和内侧皮质支撑的连接，因此也最大限度地降低了骨折不愈合的风险。
