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对比多枚螺钉固定与角度固定装置治疗股骨颈基底部骨折的手术效果。

Comparison of the Surgical Outcome between the Multiple Screw Fixation and Fixed Angle Devices for the Basicervical Femoral Neck Fractures.

机构信息

Department of Orthopaedic Surgery, Nowon Eulji Medical Center, Seoul 01830, Republic of Korea.

Department of Orthopaedic Surgery, Seoul National Bundang Hospital, Seongnam-si 13620, Republic of Korea.

出版信息

Medicina (Kaunas). 2024 Apr 23;60(5):680. doi: 10.3390/medicina60050680.

DOI:10.3390/medicina60050680
PMID:38792863
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11123322/
Abstract

: Basicervical femoral neck fracture (FNF) is an uncommon type of femoral neck fracture and is associated with an increased risk of fixation failure due to its inherent instability. The purpose of this study was to compare the surgical parameters and reoperation rate between the use of a multiple cannulated screw (MCS) and fixed angle device (FAD) in treating basicervical FNFs. : We retrospectively reviewed the records of 885 patients who underwent internal fixation between May 2004 and August 2019 to determine basicervical FNF with at least 12 months of follow-up. Among the identified 77 patients with basicervical FNF, 17 patients who underwent multiple cannulated screw (MCS) fixation and 36 patients who underwent fixed angle device (FAD) fixation were included. We compared the rates of fracture-site collapse and reoperations according to the fixation device. : Among the 53 patients with basicervical FNF, 13 patients (24.5%) sustained surgical complications (8 collapses of fracture site and 5 reoperations). The reoperation rate in the MCS group was significantly higher than that in the FAD group (23.5% vs. 2.8%, = 0.016), without any significant difference in the collapse of the fracture site (11.8% vs. 16.7%, = 0.642). : Although basicervical FNF was rare among hip fractures, fracture site collapse was prevalent and prone to fixation failure. Surgeons should keep this in mind, and consider FAD for basicervical FNF.

摘要

: 基底股骨颈骨折(FNF)是一种不常见的股骨颈骨折类型,由于其固有不稳定性,固定失败的风险增加。本研究的目的是比较使用多钉(MCS)和固定角度装置(FAD)治疗基底股骨颈 FNF 的手术参数和再次手术率。: 我们回顾性分析了 2004 年 5 月至 2019 年 8 月期间接受内固定治疗的 885 例患者的记录,以确定至少有 12 个月随访的基底股骨颈 FNF。在确定的 77 例基底股骨颈 FNF 患者中,有 17 例接受多钉(MCS)固定,36 例接受固定角度装置(FAD)固定。我们根据固定装置比较了骨折部位塌陷和再次手术的发生率。: 在 53 例基底股骨颈 FNF 患者中,13 例(24.5%)发生手术并发症(8 例骨折部位塌陷和 5 例再次手术)。MCS 组的再次手术率明显高于 FAD 组(23.5%比 2.8%, = 0.016),骨折部位塌陷无显著差异(11.8%比 16.7%, = 0.642)。: 尽管基底股骨颈 FNF 在髋部骨折中很少见,但骨折部位塌陷很常见,容易发生固定失败。外科医生应该牢记这一点,并考虑对基底股骨颈 FNF 使用 FAD。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5788/11123322/04e1aa9bdf54/medicina-60-00680-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5788/11123322/caf5a803a399/medicina-60-00680-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5788/11123322/f24ae16a0f02/medicina-60-00680-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5788/11123322/04e1aa9bdf54/medicina-60-00680-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5788/11123322/caf5a803a399/medicina-60-00680-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5788/11123322/f24ae16a0f02/medicina-60-00680-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5788/11123322/04e1aa9bdf54/medicina-60-00680-g003.jpg

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本文引用的文献

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Clin Orthop Surg. 2024 Apr;16(2):184-193. doi: 10.4055/cios23190. Epub 2024 Feb 27.
2
Prognostic Factors for Functional Recovery at 1-Year Following Fragility Hip Fractures.脆性髋部骨折后 1 年功能恢复的预后因素。
Clin Orthop Surg. 2024 Feb;16(1):7-15. doi: 10.4055/cios23177. Epub 2023 Dec 15.
3
Extramedullary versus intramedullary fixation of unstable trochanteric femoral fractures (AO type 31-A2): a systematic review and meta-analysis.
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Arch Orthop Trauma Surg. 2024 Mar;144(3):1189-1209. doi: 10.1007/s00402-023-05138-9. Epub 2024 Jan 4.
4
Risk Factors Associated with Fixation Failure in Intertrochanteric Fracture Treated with Cephalomedullary Nail.与采用髓内钉治疗的股骨转子间骨折固定失败相关的危险因素。
Hip Pelvis. 2023 Sep;35(3):193-199. doi: 10.5371/hp.2023.35.3.193. Epub 2023 Sep 6.
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A biomechanical comparison of three fixation methods for unstable femoral neck fractures with medial calcar defect.三种固定方法治疗合并内侧骨皮质缺损的不稳定股骨颈骨折的生物力学比较
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