Şahin Adem, Agar Anıl, Gülabi Deniz, Ertürk Cemil
Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği, 34303 Küçükçekmece, İstanbul, Türkiye.
Jt Dis Relat Surg. 2020;31(2):320-327. doi: 10.5606/ehc.2020.73416. Epub 2020 Jun 18.
This study aims to compare the results of internal fixation with dynamic hip screw (DHS)/antirotation screw and conventional cannulated screw (CS) for femoral neck fracture.
This retrospective study included a total of 78 patients (57 males, 21 females) with collum femoris fractures treated with internal fixation between January 2015 and January 2019. Group 1 comprised 41 patients with a mean age of 45.7 years (range, 19 to 62 years) treated with DHSs/antirotation screws, while group 2 comprised 37 patients with a mean age of 41.9 years (range, 17 to 75 years) treated with CSs. The patients were evaluated for union, avascular necrosis (AVN), femoral neck shortness, operation time, duration of fluoroscopy exposure, and functional outcomes.
Age, gender, and Garden classification stages were similar in both groups. No significant difference was found between the groups in respect of AVN and non-union rates. The non-union rate was 12.2% in group 1 and 21.6% in group 2 (p>0.05). The duration of fluoroscopy exposure was statistically significantly higher in group 2 (p=0.001) and the operation time was statistically significantly longer in group 1 (p=0.001). In group 2, femoral neck shortness stature was significantly higher (p=0.007). At the final follow-up examination, the Harris hip score was statistically significantly higher in group 1 (p=0.04).
Dynamic hip screw/antirotation screw was a more relevant treatment method for transcervical femoral neck fractures compared to CS with more favorable functional outcomes and less fluoroscopy exposure.
本研究旨在比较动力髋螺钉（DHS）/抗旋转螺钉与传统空心螺钉（CS）内固定治疗股骨颈骨折的效果。
本回顾性研究纳入了2015年1月至2019年1月期间接受内固定治疗的78例股骨颈骨折患者（57例男性，21例女性）。第1组包括41例平均年龄45.7岁（范围19至62岁）的患者，采用DHS/抗旋转螺钉治疗；第2组包括37例平均年龄41.9岁（范围17至75岁）的患者，采用CS治疗。对患者进行愈合、缺血性坏死（AVN）、股骨颈缩短、手术时间、透视暴露时间及功能结局评估。
两组患者的年龄、性别及Garden分型阶段相似。两组在AVN和不愈合率方面无显著差异。第1组不愈合率为12.2%，第2组为21.6%（p>0.05）。第2组透视暴露时间在统计学上显著更长（p=0.001），第1组手术时间在统计学上显著更长（p=0.001）。第2组股骨颈缩短情况显著更严重（p=0.007）。在末次随访检查时，第1组Harris髋关节评分在统计学上显著更高（p=0.04）。
与CS相比，动力髋螺钉/抗旋转螺钉是治疗经颈型股骨颈骨折更合适的治疗方法，功能结局更优，透视暴露更少。
