Department of Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, Japan.
Clin Orthop Surg. 2021 Dec;13(4):449-455. doi: 10.4055/cios20202. Epub 2021 Aug 17.
Dual SC screw (DSCS) is a unique concept internal fixation device consisting of a sliding screw and barrel assembly that enables compression force to be applied to the femoral neck fracture side. There are two types of barrels: a thread barrel and a plate barrel that has a one-holed side plate to prevent varus deformity. We report clinical results of the application of a DSCS with combined use of a thread barrel screw as an anti-rotational screw and a plate barrel screw as a compression hip screw.
We used DSCS for femoral neck fractures in 196 hip joints of 190 patients between November 2005 and June 2017. Among them, 70 hips in 66 patients (13 men and 53 women; mean age, 73.2 years) were followed up for at least 24 months. There were 53 nondisplaced fractures (Garden's classification stage 1 or 2) and 17 displaced fractures (stage 3 or 4). We evaluated the postoperative walking ability of the patients who were followed up for at least 24 months and examined details of all complications.
The mean follow-up period was 37.4 months (range, 24-144 months). Forty-two (64%) out of the 66 patients who were followed up for at least 2 years were able to walk independently with or without a cane. The incidence of complications was 11.5% in nondisplaced fractures and 17.5% in displaced fractures, and arthroplasty was required in 5.8% and 5.0%, respectively. The most frequent complication was secondary displacement including cutout and shortening of the femoral neck, but no implants showed varus displacement.
The application of DSCS for the treatment of femoral neck fractures had satisfactory results. The complication rate was low, and there was no postoperative varus displacement of DSCS in either displaced or nondisplaced fractures. We suggest DSCS is a reliable option for both displaced and nondisplaced femoral neck fractures.
双滑动加压螺钉(DSCS)是一种独特的内固定装置,由滑动螺钉和筒形件组成,可将加压力施加到股骨颈骨折侧。筒形件有两种类型:一种是螺纹筒形件,另一种是带有单孔侧板的钢板筒形件,以防内翻畸形。我们报告了应用 DSCS 治疗股骨颈骨折的临床结果,其中使用螺纹筒形螺钉作为抗旋转螺钉,钢板筒形螺钉作为加压髋螺钉。
我们在 2005 年 11 月至 2017 年 6 月期间使用 DSCS 治疗了 190 名患者的 196 个髋关节股骨颈骨折。其中,70 髋(66 例患者中有 13 名男性和 53 名女性;平均年龄 73.2 岁)至少随访 24 个月。53 髋为无移位骨折(Garden 分类 1 或 2 期),17 髋为移位骨折(3 或 4 期)。我们评估了至少随访 24 个月的患者术后行走能力,并检查了所有并发症的详细情况。
平均随访时间为 37.4 个月(范围:24-144 个月)。至少随访 2 年的 66 例患者中有 42 例(64%)能够独立行走,无需拐杖或使用拐杖。无移位骨折的并发症发生率为 11.5%,移位骨折的并发症发生率为 17.5%,分别需要关节置换的患者为 5.8%和 5.0%。最常见的并发症是继发性移位,包括股骨头颈切割和缩短,但没有出现内翻畸形。
DSCS 治疗股骨颈骨折的效果令人满意。并发症发生率低,无论是移位还是无移位骨折,DSCS 均无术后内翻移位。我们建议 DSCS 是治疗移位和无移位股骨颈骨折的可靠选择。