Department of Trauma Surgery, Medisch Spectrum Twente, Koningstraat 1, Enschede, 7512 KZ, The Netherlands.
Department of Trauma Surgery, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands.
Eur J Trauma Emerg Surg. 2024 Oct;50(5):2219-2227. doi: 10.1007/s00068-024-02552-5. Epub 2024 May 31.
This study aimed to investigate the long-term outcomes of patients with a femoral neck fracture (FNF), treated with the Dynamic Locking Blade Plate (DLBP).
Retrospective analysis of prospectively collected data of a multicentre cohort of patients with FNFs was conducted, regarding the long-term incidence of revision surgery after DLBP. Implant failure was evaluated using Kaplan-Meier and Cox regression analysis. Secondary outcomes were the indication for revision surgery, complications, time to revision surgery, rate of elective removal of the implant, potential predictors for revision surgery and mortality.
Median follow-up of 389 included patients was 98 months; 20.6% underwent revision surgery; 28.8% after treatment of a displaced FNF (dFNF) and 10.0% with a undisplaced FNF (uFNF). 5.7% (n = 22) of the patients had operation related complications and 32.9% (n = 128) deceased during follow-up. Median time to revision surgery was 13 (dFNF) and 18 months (uFNF). 15.7% of the DLBPs were electively removed. In the multivariate Cox regression analysis, female gender (hazard ratio 2.1, 95% CI 1.2-3.7) and a TAD > 25 mm (hazard ratio 2.9, 95% CI 1.7-5) were significant predictors for revision surgery in patients with dFNF.
This study is the first long-term follow-up study on the outcome of the DLBP. The DLBP demonstrated positive long-term results in the treatment of FNF.
本研究旨在探讨股骨颈骨折(FNF)患者采用动力锁定刀片钢板(DLBP)治疗的长期疗效。
对多中心队列中 FNF 患者前瞻性收集数据进行回顾性分析,研究 DLBP 后翻修手术的长期发生率。采用 Kaplan-Meier 和 Cox 回归分析评估植入物失败。次要结局包括翻修手术的指征、并发症、翻修手术时间、选择性去除植入物的比例、翻修手术的潜在预测因素和死亡率。
纳入的 389 例患者的中位随访时间为 98 个月;20.6%的患者接受了翻修手术;28.8%的患者治疗为移位性股骨颈骨折(dFNF),10.0%的患者为非移位性股骨颈骨折(uFNF)。5.7%(n=22)的患者发生手术相关并发症,32.9%(n=128)在随访期间死亡。dFNF 患者的中位翻修手术时间为 13 个月,uFNF 患者为 18 个月。15.7%的 DLBP 被选择性去除。在多变量 Cox 回归分析中,女性(危险比 2.1,95%置信区间 1.2-3.7)和 TAD>25mm(危险比 2.9,95%置信区间 1.7-5)是 dFNF 患者翻修手术的显著预测因素。
这是 DLBP 治疗 FNF 结果的首次长期随访研究。DLBP 在治疗 FNF 方面表现出良好的长期效果。