Department of Orthopaedic Surgery, Ningbo No.6 Hospital, Ningbo 315040, China.
J Healthc Eng. 2022 Feb 16;2022:1286419. doi: 10.1155/2022/1286419. eCollection 2022.
To compare the clinical effect of proximal femoral locking plate (PFLP) versus multiple cancellous screw (MCS) for FNF.
FNF patients were treated with the PFLP implant or multiple cancellous screws (MCSs). Patient has been followed up for at least 12 months after surgery nonunion, and the occurrence of complications, femoral neck shortening, fracture healing time, and Harris hip score were recorded and compared.
77 FNF patients were treated with the PFLP (36 patients) or MCS (41 patients). The sex, age, side of the injured limb, type of Garden fracture, time from injury to surgery, and fracture healing time of two groups patients were comparable. The operation time and intraoperative blood loss in the PFLP group were worse than those in the MCS group. Two patients with the PFLP (5%) and nine patients (21%) with the MCS experienced cut out of the lag screw or avascular necrosis of the femoral head or nonunion and received hip replacement. However, the number of fluoroscopies in the PFLP group was significantly lower than that in the MCS group. Additionally, the femoral neck shortening and Harris hip score were all strongly better in the PFLP group than in the MCS group.
Compared with the MCS, PFLP treatment for FNF in young adults can decrease the fluoroscopy times, improve hip functional recovery, and reduce the complications rate and femoral neck shortening.
比较股骨近端锁定钢板（PFLP）与多枚松质骨螺钉（MCS）治疗股骨颈骨折不愈合（FNF）的临床效果。
FNF 患者分别采用 PFLP 植入物或多枚松质骨螺钉（MCSs）治疗。术后至少随访 12 个月，记录并比较两组患者的骨折不愈合、并发症发生情况、股骨颈缩短、骨折愈合时间和 Harris 髋关节评分。
77 例 FNF 患者分别采用 PFLP（36 例）或 MCS（41 例）治疗。两组患者的性别、年龄、患侧、Garden 骨折类型、受伤至手术时间和骨折愈合时间比较，差异均无统计学意义。PFLP 组的手术时间和术中出血量均差于 MCS 组。PFLP 组有 2 例（5%）和 MCS 组有 9 例（21%）患者出现拉力螺钉切出或股骨头缺血性坏死或骨折不愈合，需要接受髋关节置换。然而，PFLP 组的 X 光透视次数明显低于 MCS 组。此外，PFLP 组的股骨颈缩短和 Harris 髋关节评分均明显优于 MCS 组。
与 MCS 相比，PFLP 治疗年轻成人 FNF 可减少 X 光透视次数，改善髋关节功能恢复，并降低并发症发生率和股骨颈缩短。
