Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, 13353 Berlin, Germany.
Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.
Medicina (Kaunas). 2022 Feb 26;58(3):352. doi: 10.3390/medicina58030352.
Background and Objective: Various fixation devices and surgical techniques are available for the management of proximal femur fractures. Recently, the femoral neck system (FNS) was introduced, and was promoted on the basis of less invasiveness, shorter operating time, and less fluoroscopy time compared to previous systems. The aim of this study was to compare two systems for the internal fixation of femoral neck fractures (FNF), namely the dynamic hip screw (DHS) with an anti-rotation screw (ARS) and an FNS. The outcome measures included operating room time (ORT), dose−area product (DAP), length of stay (LOS), perioperative changes in haemoglobin concentrations, and transfusion rate. Materials and Methods: A retrospective single-centre study was conducted. Patients treated for FNF between 1 January 2020 and 30 September 2021 were included, provided that they had undergone closed reduction and internal fixation. We measured the centrum-collum-diaphyseal (CCD) and the Pauwels angle preoperatively and one week postoperatively. Results: In total, 31 patients (16 females), with a mean age of 62.81 ± 15.05 years, were included. Fracture complexity assessed by the Pauwels and Garden classification did not differ between groups preoperatively. Nonetheless, the ORT (54 ± 26.1 min vs. 91.68 ± 23.96 min, p < 0.01) and DAP (721 ± 270.6 cGycm² vs. 1604 ± 1178 cGycm², p = 0.03) were significantly lower in the FNS group. The pre- and postoperative CCD and Pauwels angles did not differ statistically between groups. Perioperative haemoglobin concentration changes (−1.77 ± 1.19 g/dl vs. −1.74 ± 1.37 g/dl) and LOS (8 ± 5.27 days vs. 7.35 ± 3.43 days) were not statistically different. Conclusions: In this cohort, the ORT and DAP were almost halved in the patient group treated with FNS. This may confer a reduction in secondary risks related to surgery.
对于股骨近端骨折，有多种固定装置和手术技术可供选择。最近，股骨颈系统（FNS）问世，与之前的系统相比，其具有创伤更小、手术时间更短、透视时间更短等优点。本研究旨在比较两种股骨颈骨折内固定系统（FNF），即动力髋螺钉（DHS）联合防旋螺钉（ARS）与 FNS，测量手术间时间（ORT）、剂量面积乘积（DAP）、住院时间（LOS）、围手术期血红蛋白浓度变化和输血率等指标。
回顾性单中心研究。纳入 2020 年 1 月 1 日至 2021 年 9 月 30 日期间接受闭合复位内固定治疗的 FNF 患者，测量术前和术后一周的中心干骺端角（CCD）和 Pauwels 角。
共纳入 31 例患者（16 例女性），平均年龄 62.81±15.05 岁。术前 Pauwels 和 Garden 骨折分型评估的骨折复杂性在两组间无差异。然而，FNS 组的 ORT（54±26.1 min 比 91.68±23.96 min，p<0.01）和 DAP（721±270.6 cGycm² 比 1604±1178 cGycm²，p=0.03）显著降低。两组间术前和术后 CCD 及 Pauwels 角无统计学差异。围手术期血红蛋白浓度变化（-1.77±1.19 g/dl 比-1.74±1.37 g/dl）和 LOS（8±5.27 d 比 7.35±3.43 d）无统计学差异。
在本队列中，FNS 治疗组的 ORT 和 DAP 几乎减半。这可能降低与手术相关的继发性风险。
