Wang Xiaopan, Wu Min, Chen Xiaotian, Ye Longfei, Dai Xiusong
Department of Orthopaedics, Anhui Key Laboratory of Tissue Transplantation, the First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233004, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Mar 15;37(3):272-276. doi: 10.7507/1002-1892.202212043.
To evaluate the feasibility and effectiveness of percutaneous screwdriver rod-assisted closed reduction in the treatment of valgus-impacted femoral neck fractures.
Between January 2021 and May 2022, 12 patients with the valgus-impacted femoral neck fractures were treated with percutaneous screwdriver rod-assisted closed reduction and femoral neck system (FNS) internal fixation. There were 6 males and 6 females with a median age of 52.5 years (range, 21-63 years). The fractures were caused by traffic accident in 2 cases, falling in 9 cases, and falling from height place in 1 case. All were unilateral closed femoral neck fractures, including 7 on the left side and 5 on the right side. The time from injury to operation was 1-11 days, with an average of 5.5 days. The fracture healing time and postoperative complications were recorded. The quality of fracture reduction was evaluated by Garden index. At last follow-up, Harris score was used to evaluate the hip joint function, also the shortening of femoral neck was measured.
All the operations were successfully completed. After operation, the incision fat liquefaction occurred in 1 case, which healed after enhanced dressing change, and the other patients' incisions healed by first intention. All patients were followed up 6-18 months, with an average of 11.7 months. The X-ray film reexamination showed that the quality of fracture reduction was grade Ⅰ in 10 cases and grade Ⅱ in 2 cases according to the Garden index. All fractures reached bony union, and the healing time was 3-6 months, with an average of 4.8 months. At last follow-up, the femoral neck was shortened by 1-4 mm, with an average of 2.1 mm. No internal fixation failure or osteonecrosis of the femoral head occurred during follow-up. At last follow-up, the hip Harris score was 85-96, with an average of 92.4; 10 cases were rated as excellent and 2 were good.
The percutaneous screwdriver rod-assisted closed reduction can effectively reduce the valgus-impacted femoral neck fracture. It has the advantages of simple operation, effective, and less impact on blood supply.
评估经皮螺丝刀棒辅助闭合复位治疗外翻嵌插型股骨颈骨折的可行性和有效性。
2021年1月至2022年5月，对12例外翻嵌插型股骨颈骨折患者采用经皮螺丝刀棒辅助闭合复位及股骨颈系统（FNS）内固定治疗。其中男性6例，女性6例，中位年龄52.5岁（范围21 - 63岁）。骨折原因：交通事故2例，跌倒9例，高处坠落1例。均为单侧闭合性股骨颈骨折，左侧7例，右侧5例。受伤至手术时间为1 - 11天，平均5.5天。记录骨折愈合时间及术后并发症。采用Garden指数评估骨折复位质量。末次随访时，采用Harris评分评估髋关节功能，并测量股骨颈缩短情况。
所有手术均顺利完成。术后1例出现切口脂肪液化，经加强换药后愈合，其余患者切口均一期愈合。所有患者随访6 - 18个月，平均11.7个月。X线片复查显示，根据Garden指数，骨折复位质量Ⅰ级10例，Ⅱ级2例。所有骨折均达到骨性愈合，愈合时间为3 - 6个月，平均4.8个月。末次随访时，股骨颈缩短1 - 4mm，平均2.1mm。随访期间未发生内固定失败或股骨头坏死。末次随访时，髋关节Harris评分为85 - 96分，平均92.4分；优10例，良2例。
经皮螺丝刀棒辅助闭合复位可有效复位外翻嵌插型股骨颈骨折。具有操作简单、效果确切、对血供影响小等优点。
