Department of Orthopaedic Surgery, HongHui Hospital, Xi'an Jiaotong University, 555Youyi East Road, Xi'an 710054, Shaan'xi Province, China.
Yan'an University, Yan'an, 710000, Shaanxi, China.
BMC Musculoskelet Disord. 2021 Nov 29;22(1):994. doi: 10.1186/s12891-021-04888-0.
To compare the clinical efficacy of a femoral neck system (FNS) and cannulated screws (CS) in the treatment of femoral neck fracture in young adults.
Data from 69 young adults, who were admitted for femoral neck fracture between March 2018 and June 2020, were retrospectively analyzed. Patients were divided into two groups according to surgical method: FNS and CS. The number of intraoperative fluoroscopies, operative duration, length of hospital stay, fracture healing time, Harris score of hip function, excellent and good rate of hip function, and postoperative complications (infection, cut out the internal fixation, nail withdrawal, and femoral neck shortening) were compared between the two groups. Hip joint function was evaluated using the Harris Hip Scoring system.
All 69 patients had satisfactory reduction and were followed up for 12-24 months, with a mean follow-up of 16.91 ± 3.01 months. Mean time to fracture healing was13.82 ± 1.59 and 14.03 ± 1.78 weeks in the FNS and CS groups, respectively. There was a statistical difference in the number of intraoperative fluoroscopies between the 2 groups (P = 0.000). There were no significant differences, in operation duration, hospital length of stay, fracture healing time, complications, Harris Hip Score for hip function and excellent and good rate between the two groups (P > 0.05). The incidence of complications was 6.1%(2/33) in the FNS group lower than 25%(9/36) in the CS group, a difference that was statistically significant (P = 0.032). At the last follow-up, the Harris Hip Score of the hip joint in the FNS group was 90.42 ± 4.82and 88.44 ± 5.91 in the CS group.
Both treatment methods resulted in higher rates of fracture healing and excellent hip function. Compared with CS, the FNS reduced the number of intraoperative fluoroscopies, radiation exposure to medical staff and patients, and short-term complications including femoral neck shortening and bone nonunion.
比较股骨颈系统(FNS)和空心螺钉(CS)治疗青年股骨颈骨折的临床疗效。
回顾性分析 2018 年 3 月至 2020 年 6 月收治的 69 例青年股骨颈骨折患者的临床资料,根据手术方法分为 FNS 组和 CS 组。比较两组患者术中透视次数、手术时间、住院时间、骨折愈合时间、髋关节功能 Harris 评分、髋关节功能优良率及术后并发症(感染、内固定物切出、钉拔出、股骨颈缩短)。采用 Harris 髋关节评分系统评估髋关节功能。
所有患者均获得满意复位,随访 12-24 个月,平均随访 16.91±3.01 个月。FNS 组和 CS 组骨折愈合时间分别为 13.82±1.59 和 14.03±1.78 周,两组术中透视次数比较,差异有统计学意义(P=0.000)。两组手术时间、住院时间、骨折愈合时间、并发症发生率、髋关节功能 Harris 评分及优良率比较,差异均无统计学意义(P>0.05)。FNS 组并发症发生率为 6.1%(2/33),低于 CS 组的 25%(9/36),差异有统计学意义(P=0.032)。末次随访时,FNS 组髋关节 Harris 评分 90.42±4.82,CS 组 88.44±5.91。
两种治疗方法均能获得较高的骨折愈合率和优良的髋关节功能。与 CS 相比,FNS 减少了术中透视次数,降低了医护人员和患者的辐射暴露,且短期并发症(包括股骨颈缩短和骨不愈合)发生率较低。