Department of Orthopaedics, Fuzhou Second General Hospital, Fuzhou Second Hospital of Xiamen University, School of Clinical Medicine of Fujian Medical University, Fujian Provincial Clinical Medical Research Center for First Aid and Rehabilitation in Orthopaedic Trauma, Fuzhou, 350007, China.
Sci Rep. 2024 Jul 15;14(1):16281. doi: 10.1038/s41598-024-67260-x.
In femoral neck fractures the secondary damage caused by repeated multiple reductions needs to be prevented. Accordingly, the aim of this study was to achieve an anatomical reduction in the first manipulation of reduction in femoral neck fractures. We propose a new reduction strategy using the x-ray morphology of femoral neck fractures for preoperative planning. In the present study we compared this approach to conventional operation procedures for the treatment of femoral neck fractures. From 2020 to 2021, 35 patients with femoral neck fractures were operated with this reduction strategy. Those were compared with 34 patients treated without the proposed preoperative method. All patients were compared for consistency between the preoperative assessment and the intraoperative execution of the reduction approach, number of reductions, operative time, number of fluoroscopies, intraoperative bleeding, and reduction quality. The operative time of patients in the study group was significantly shorter (38.40 ± 10.26 min) than that of the control group (47.26 ± 9.09 min), and the number of reductions [1.0 (1.0, 1.0)] was significantly less than that of the control group [2.0 (1.75, 2.25)]. The number of fluoroscopies (10.27 ± 2.84) was also significantly less than that of the control group (13.53 ± 2.59) times. The KAPPA value = 0.886 shows the good agreement between the preoperative proposed protocol and the intraoperative protocol about the study group .The bleeding, quality of repositioning, Harris Hip score, MOS 12-item Short Form Survey (SF-12), and early complication rate were not statistically different between the groups (P > 0.05). The selection of the appropriate repositioning method based on the analysis of femoral neck fracture X-ray morphology can improve the efficiency and accuracy of preoperative planning. This reduces the secondary damage that may be caused by multiple reduction, shortens the operation time and reduces the exposure to radiation.
在股骨颈骨折中，需要防止反复多次复位造成的继发性损伤。因此，本研究的目的是在首次复位操作中实现股骨颈骨折的解剖复位。我们提出了一种新的复位策略，利用股骨颈骨折的 X 射线形态进行术前规划。在本研究中，我们将这种方法与股骨颈骨折的传统手术方法进行了比较。2020 年至 2021 年，35 例股骨颈骨折患者采用这种复位策略进行手术。将这些患者与 34 例未采用术前建议方法治疗的患者进行比较。比较了所有患者术前评估与术中复位方法执行的一致性、复位次数、手术时间、透视次数、术中出血量和复位质量。研究组患者的手术时间明显短于对照组（38.40±10.26min），复位次数[1.0（1.0，1.0）]明显少于对照组[2.0（1.75，2.25）]。透视次数（10.27±2.84 次）也明显少于对照组（13.53±2.59 次）。研究组的 KAPPA 值为 0.886，表明术前提出的方案与术中方案之间具有良好的一致性。术中出血量、复位质量、Harris 髋关节评分、MOS 12 项简明健康调查问卷（SF-12）和早期并发症发生率在两组间无统计学差异（P>0.05）。根据股骨颈骨折 X 射线形态分析选择合适的复位方法，可以提高术前规划的效率和准确性。这可以减少多次复位可能造成的继发性损伤，缩短手术时间，减少辐射暴露。
