Lin Hongkuan, Lai Caosheng, Zhou Zhiping, Wang Chaoqiang, Yu Xinlin
Department of Orthopedics, Mindong Hospital of Fujian Medical University, Fu'an, Fujian 355000, PR China.
Department of Orthopedics, Mindong Hospital of Fujian Medical University, Fu'an, Fujian 355000, PR China.
J Orthop Sci. 2023 Nov;28(6):1373-1378. doi: 10.1016/j.jos.2022.09.006. Epub 2022 Oct 10.
To compare the clinical efficacy of the Femoral Neck System (FNS) vs. four cannulated screws in Pauwels III femoral neck fractures.
This retrospective study included patients with newly occurred type Pauwels III femoral neck fracture treated at author' Hospital of between January 2017 and February 2021. The patients received FNS (n = 27) or four cannulated screws (control group, n = 31). The operation time, blood loss, fracture healing time, incidence of complications (such as short femoral neck, necrosis of femoral head, nonunion of fracture, and failure of internal fixation withdrawal), and hip Harris score at the last follow-up were analyzed.
The operation time, blood loss, and fracture healing time were not significantly different between the two groups (all P > 0.05). In the FNS group, three and one patients were with femoral neck shortening and femoral head necrosis, respectively, while no fracture nonunion or failure of internal fixation withdrawal occurred. In the control group, seven, two, one, and two patients were with femoral neck shortening, femoral head necrosis, nonunion, and internal fixation failure, respectively. The cumulative complication incidence was 14.8% and 38.7% in the FNS and control groups (P = 0.042). The excellent and good rates of the hip Harris score at the last follow-up were 92.6% and 71.0% in the FNS and control groups, respectively (P = 0.036).
The study suggested that the clinical efficacy of FNS was better than internal fixation using four cannulated screws in treating Pauwels III type femoral neck fracture.
比较股骨颈系统（FNS）与四枚空心螺钉治疗 Pauwels III 型股骨颈骨折的临床疗效。
本回顾性研究纳入了 2017 年 1 月至 2021 年 2 月在作者所在医院接受治疗的新发 Pauwels III 型股骨颈骨折患者。患者接受 FNS 治疗（n = 27）或四枚空心螺钉治疗（对照组，n = 31）。分析手术时间、失血量、骨折愈合时间、并发症发生率（如股骨颈缩短、股骨头坏死、骨折不愈合和内固定取出失败）以及末次随访时的髋关节 Harris 评分。
两组的手术时间、失血量和骨折愈合时间差异均无统计学意义（均 P > 0.05）。FNS 组分别有 3 例和 1 例患者发生股骨颈缩短和股骨头坏死，未发生骨折不愈合或内固定取出失败。对照组分别有 7 例、2 例、1 例和 2 例患者发生股骨颈缩短、股骨头坏死、骨折不愈合和内固定失败。FNS 组和对照组的累积并发症发生率分别为 14.8%和 38.7%（P = 0.042）。末次随访时，FNS 组和对照组的髋关节 Harris 评分优良率分别为 92.6%和 71.0%（P = 0.036）。
本研究表明，在治疗 Pauwels III 型股骨颈骨折方面，FNS 的临床疗效优于使用四枚空心螺钉进行内固定。
