Xu Xiangyu, Fan Jixing, Zhou Fang, Lv Yang, Tian Yun, Ji Hongquan, Zhang Zhishan, Guo Yan, Yang Zhongwei, Hou Guojin
Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China; Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China.
Department of Orthopedics, Peking University Third Hospital, Beijing 100191, China; Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China.
Injury. 2023 Apr;54 Suppl 2:S28-S35. doi: 10.1016/j.injury.2022.03.041. Epub 2022 Mar 25.
To compare the short-term outcomes of the femoral neck system (FNS) with multiple cancellous screws (MCS) and dynamic hip screws (DHS) in the treatment of femoral neck fractures.
A retrospective analysis was performed on 157 patients with fresh femoral neck fractures treated with FNS (from September 2019 to October 2020), MCS, and DHS (from January 2018 to October 2020). According to internal fixation methods, all patients were divided into the FNS group (54 cases), MCS group (51 cases), and DHS group (52 cases). Demographic data were also collected, recorded, and compared, including the follow-up time, days of hospitalization, operation time, blood loss, intraoperative fluoroscopy times (IFT), weight-bearing time (WBT), length of femoral neck shortening (LFNS), Harris hip score, and complications (such as internal fixation failure, bone nonunion, and avascular necrosis of the femoral head) between the three groups.
Overall, 157 patients with a mean age of 61.8 (range, 18-89) years were analyzed. In the FNS group, IFT (median 10.5) was significantly lower than that in the MCS group (median 21) and DHS group (median 20.5) (P<0.05), and WBT was significantly earlier than that of the MCS group (P<0.05). In the FNS group, the median hospitalization time, operation time, and blood loss were 2 (2, 4) days, 45 (40-59) min, and 30 (20, 50) ml, respectively. They were all significantly less than 3.5 (3, 6) days, 72 (55-88.75) min, and 50 (30, 50) ml in the DHS group, respectively (P < 0.05). There was no statistical difference in LFNS, quality of reduction, internal fixation failure rate, and Harris hip score at the latest follow-up (P>0.05). No surgical complications such as incision infection, deep infection, pulmonary embolism, or femoral head necrosis were found in any of the three groups.
FNS, MCS, and DHS are all effective for femoral neck fractures. However, a lower IFT of FNS shortens the operation time. Compared to MCS, FNS has the advantages of being a simple operation, with early WBT; compared to DHS, a minimally invasive operation is the main advantage of FNS.
比较股骨颈系统（FNS）、多枚松质骨螺钉（MCS）和动力髋螺钉（DHS）治疗股骨颈骨折的短期疗效。
对157例新鲜股骨颈骨折患者进行回顾性分析，其中FNS组（2019年9月至2020年10月）54例，MCS组和DHS组（2018年1月至2020年10月）各51例和52例。收集、记录并比较三组患者的人口统计学数据，包括随访时间、住院天数、手术时间、失血量、术中透视次数（IFT）、负重时间（WBT）、股骨颈缩短长度（LFNS）、Harris髋关节评分及并发症（如内固定失败、骨不连和股骨头缺血性坏死）。
共分析157例患者，平均年龄61.8（18 - 89）岁。FNS组的IFT（中位数10.5）显著低于MCS组（中位数21）和DHS组（中位数20.5）（P<0.05），且WBT早于MCS组（P<0.05）。FNS组的住院时间中位数、手术时间和失血量分别为2（2, 4）天、45（40 - 59）分钟和30（20, 50）毫升，均显著少于DHS组的3.5（3, 6）天、72（55 - 88.75）分钟和50（30, 50）毫升（P<0.05）。最新随访时，三组在LFNS、复位质量、内固定失败率和Harris髋关节评分方面无统计学差异（P>0.05）。三组均未发现切口感染、深部感染、肺栓塞或股骨头坏死等手术并发症。
FNS、MCS和DHS治疗股骨颈骨折均有效。然而，FNS的IFT较低，缩短了手术时间。与MCS相比，FNS具有操作简单、WBT早的优势；与DHS相比，FNS的主要优势是微创手术。
