University Hospitals Derby and Burton, Derby, UK.
El-Hadra University Hospital, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
Ortop Traumatol Rehabil. 2021 Feb 28;23(1):27-32. doi: 10.5604/01.3001.0014.7565.
Intra-capsular fractures of the femoral neck in young patients are almost always treated with surgical fixation to preserve the native hip anatomy and biomechanics. Multiple Cannulated hip screws and the sliding hip screw have been the hallmark fixation devices for these injuries. The use of locking cannulated hip screws to a side plate was developed to mitigate the biological and mechanical downfalls of these devices. To report the outcome following the use of a locking plate fixation system in the management of intracapsular fractures of the femoral neck in young patients.
A case series study of all the patients treated in our institution between 2014 and 2017. All eligible patients with hip intracapsular fractures aged between 18 and 65 were treated with a proximal locking hip plate system. The main reported outcomes were union rate, failure of fixation, and development of avascular necrosis of the femoral head.
Fifty-six patients (36 men and 20 women) at a mean age of 39.1 years (range 20-65 years) completed 24 months' follow-up. Mean time to surgery was 16 hours. No intraoperative complications were reported. The mean time to union was 15.9 weeks (range 12-23). Three patients (5.3%, one Garden type III, and two type IV) did not achieve union at 6 months. Two patients had revision surgery with valgus osteotomy and the third patient required total hip replacement because of screw penetration. Five patients (8.9%) developed avascular necrosis of the femoral head (2 patients Garden type III, and 3 patients Garden VI). Only two patients required conversion to total hip replacement.
年轻患者的股骨颈囊内骨折几乎都需要手术固定，以保持髋关节的解剖结构和生物力学。多枚空心螺钉和滑动髋螺钉一直是这些损伤的标志性固定装置。使用带侧钢板的锁定空心螺钉是为了减轻这些装置的生物力学和机械学缺陷。报告在年轻患者的股骨颈囊内骨折治疗中使用锁定钢板固定系统的结果。
这是一项 2014 年至 2017 年在我院治疗的所有患者的病例系列研究。所有年龄在 18 至 65 岁之间的髋关节囊内骨折患者均采用近端锁定髋钢板系统治疗。主要报告的结果是愈合率、固定失败和股骨头缺血性坏死的发生。
56 名患者（36 名男性和 20 名女性）的平均年龄为 39.1 岁（范围 20-65 岁），完成了 24 个月的随访。平均手术时间为 16 小时。术中无并发症报告。平均愈合时间为 15.9 周（范围 12-23）。3 名患者（5.3%，1 例 Garden 型 III 型，2 例 IV 型）在 6 个月时未愈合。2 例患者行外翻截骨术，第 3 例患者因螺钉穿透而需全髋关节置换术。5 名患者（8.9%）发生股骨头缺血性坏死（2 例 Garden 型 III 型，3 例 Garden VI 型）。仅 2 例患者需要转换为全髋关节置换术。
