Stappaerts K H, Broos P L
Acta Chir Belg. 1987 Jul-Aug;87(4):247-51.
A retrospective study of 118 femoral neck fractures treated with multiple Knowles pins or with AO (ASIF) cancellous bone screws, and followed for at least 22 months, revealed nonunion in 1/33 undisplaced fractures and in 27/85 displaced fractures. Avascular necrosis was radiographically evident in respectively 2/32 and 19/58 united undisplaced and displaced fractures. Four factors were adversely associated with union: inaccurate reduction, mental confusion, age above 80 years and fixation with less than 6 Knowles pins. Late segmental collapse was not significantly related with any of the 9 analyzed factors. It was concluded that displaced femoral neck fractures in confused patients older than 80 years, or fractures one cannot adequately reduce, should be primarily treated with arthroplasty. Following accurate reduction, internal fixation with less than 6 Knowles pins cannot be recommended.
一项对118例采用多根诺尔斯针或AO（ASIF）松质骨螺钉治疗的股骨颈骨折患者进行的回顾性研究，随访至少22个月，结果显示，在33例无移位骨折中有1例发生骨不连，在85例移位骨折中有27例发生骨不连。在分别32例愈合的无移位骨折和58例愈合的移位骨折中，影像学上可见的股骨头缺血性坏死分别为2例和19例。有四个因素与骨折愈合呈负相关：复位不准确、精神错乱、年龄超过80岁以及使用少于6根诺尔斯针固定。晚期节段性塌陷与所分析的9个因素中的任何一个均无显著相关性。得出的结论是，80岁以上精神错乱患者的移位股骨颈骨折，或无法充分复位的骨折，应首选关节置换术治疗。在准确复位后，不建议使用少于6根诺尔斯针进行内固定。
