The First Clinical of Medical School, Guangzhou University of Chinese Medicine, No. 12 Jichang Road, Baiyun District, Guangzhou, 510405, Guangdong Province, China.
The Lab of Orthopaedics of Chinese Medicine of Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, Guangdong, China.
J Orthop Surg Res. 2023 Aug 5;18(1):570. doi: 10.1186/s13018-023-04002-1.
For femoral neck fractures in young and middle-aged patients, both fibula allograft with cannulated screw fixation and ordinary cannulated screw fixation are clinically effective treatments. However, for unstable femoral neck fractures, ordinary cannulated screw fixation is characterized by a high risk of postoperative complications and a high rate of mechanical failure after internal fixation. For this study, we systematically compared the long-term efficacy and postoperative complications of these two procedures.
A total of 156 subjects diagnosed as femoral neck fractures participated in our study. Subjects in the combination group underwent fibula allograft with cannulated screw fixation (n = 76), and those in the control group were treated with ordinary cannulated screw fixation (n = 80). Baseline characteristics, perioperative outcomes, Harris hip score (HHS) and EuroQoL five-dimension questionnaire (EQ-5D); and the incidence of postoperative and bone healing complications in the two groups were recorded and compared.
The average follow-up time was more than 10 years. Intra-operative blood loss significantly increased in the combination group compared with the control group (P < 0.05). There were significantly improved performances in healing time, the time course of recovery of full-weight-bearing stepping, HHS and EQ-5D scores in the combination group compared with the control group (P < 0.05). Besides, the incidence rates of femoral head necrosis, nonunion, femoral neck shortening and total hip replacement were significantly lower in the combination group than those in the control group (P < 0.05).
Fibula allograft with cannulated screw fixation shows a better long-term therapeutic effect than ordinary cannulated screw fixation for femoral neck fractures in young and middle-aged patients. Patients receiving the combination strategy have faster and high-quality functional recovery after femoral neck fractures and a lower incidence rate of postoperative complications.
对于中青年股骨颈骨折患者，腓骨同种异体骨移植联合空心螺钉固定和普通空心螺钉固定都是有效的治疗方法。然而，对于不稳定型股骨颈骨折，普通空心螺钉固定术后并发症风险高，内固定机械失败率高。本研究系统比较了两种术式的长期疗效和术后并发症。
共纳入 156 例股骨颈骨折患者。联合组采用腓骨同种异体骨移植联合空心螺钉固定（n=76），对照组采用普通空心螺钉固定（n=80）。记录并比较两组患者的基线特征、围手术期结果、Harris 髋关节评分（HHS）和欧洲五维健康量表（EQ-5D）、术后和骨愈合并发症的发生率。
平均随访时间超过 10 年。与对照组相比，联合组术中出血量明显增加（P<0.05）。联合组在愈合时间、完全负重行走恢复时间、HHS 和 EQ-5D 评分方面的表现明显优于对照组（P<0.05）。此外，联合组股骨头坏死、骨不连、股骨颈短缩和全髋关节置换的发生率明显低于对照组（P<0.05）。
腓骨同种异体骨移植联合空心螺钉固定治疗中青年股骨颈骨折的长期疗效优于普通空心螺钉固定。采用联合策略的患者在股骨颈骨折后恢复更快，功能恢复质量更高，术后并发症发生率更低。
