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股骨颈系统固定股骨颈骨折:43 例回顾性队列研究。

Fixation of femoral neck fracture with femoral neck system: a retrospective cohort study of 43 patients.

机构信息

Department of Orthopaedic Surgery, Dongguk University Ilsan Hospital, Goyang-si, Republic of Korea.

Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, Seongnam-si, Republic of Korea.

出版信息

BMC Musculoskelet Disord. 2024 Jan 2;25(1):8. doi: 10.1186/s12891-023-07113-2.

Abstract

BACKGROUNDS

This study aimed to analyze the clinical outcomes of femoral neck fractures (FNF) in patients treated with a femoral neck system (FNS, DePuy Synthes), which is a recently introduced device.

METHODS

This retrospective cohort study of 43 patients who underwent osteosynthesis using FNS for FNF between July 2019 and June 2021 with a minimum follow-up of 6 months. The researchers examined the patients' demographic factors and radiologically evaluated the fracture type and fixation status, bone union, and postoperative complications.

RESULTS

Of 43 patients, 25 were female, and the patients' mean age and body mass index were 62.1 years and 22.5 kg/m, respectively. According to the Association of Osteosynthesis/Orthopaedic Trauma Association (AO/OTA) classification, the most common fracture types were 31B1.1 and B1.2 (13 cases each), followed by B2.3, B2.1, and B2.2 (seven, five, and four cases, respectively). Radiological bone union was confirmed in 39 patients (90.7%), and the mean time to union was 3.6 months. Two cases of nonunion, one case of lag screw cut-out, and one case of osteonecrosis were confirmed; all four cases later underwent arthroplasty. The mean time to reoperation was 4.5 months. Meanwhile, five patients underwent implant removal after the bone union, and distal locking screw stripping was noted in three patients. All three patients required metal plate cutting to remove the implants.

CONCLUSIONS

Osteosynthesis of FNF using the newly introduced FNS showed favorable clinical outcomes and no specific hardware-related complications were reported during the follow-up. However, attention must be paid to the issue regarding distal locking screw failure during hardware removal.

摘要

背景

本研究旨在分析使用最近引入的股骨颈系统(FNS,DePuy Synthes)治疗股骨颈骨折(FNF)患者的临床结果。

方法

这是一项回顾性队列研究,纳入了 2019 年 7 月至 2021 年 6 月期间使用 FNS 进行股骨颈骨折内固定的 43 例患者,随访时间至少 6 个月。研究人员检查了患者的人口统计学因素,并对骨折类型和固定状态、骨愈合以及术后并发症进行了影像学评估。

结果

43 例患者中,25 例为女性,患者的平均年龄和体重指数分别为 62.1 岁和 22.5kg/m2。根据骨折的 Association of Osteosynthesis/Orthopaedic Trauma Association(AO/OTA)分类,最常见的骨折类型为 31B1.1 和 B1.2(各 13 例),其次是 B2.3、B2.1 和 B2.2(分别为 7、5 和 4 例)。39 例患者(90.7%)确认影像学愈合,愈合的平均时间为 3.6 个月。有 2 例出现骨不连,1 例出现拉力螺钉切出,1 例出现骨坏死,这 4 例患者均进行了关节置换。再次手术的平均时间为 4.5 个月。同时,5 例患者在骨愈合后取出了植入物,其中 3 例出现远端锁定螺钉脱出。所有 3 例均需使用金属板切割取出植入物。

结论

使用新引入的 FNS 治疗股骨颈骨折的内固定术显示出良好的临床结果,在随访期间未报告与特定硬件相关的并发症。然而,在取出植入物时必须注意远端锁定螺钉失效的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25e7/10759579/9a9130e2ea2b/12891_2023_7113_Fig1_HTML.jpg

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