Technol Health Care. 2024;32(6):4009-4017. doi: 10.3233/THC-231547.
Femoral neck fractures, which are fractures occurring from the femoral head to the base of the femoral neck, are prevalent in the elderly population. With the progression of societal aging, the incidence of femoral neck fractures has been steadily increasing, making it a significant global issue that urgently needs to be addressed.
To compare the efficacy and safety of dynamic hip screw (DHS) with anti-rotation screw and femoral neck system (FNS) internal fixation for the treatment of Garden II-IV type femoral neck fractures.
A total of 90 patients with Garden II-IV type femoral neck fractures were randomly assigned to either the control group (n= 45) treated with DHS and anti-rotation screw or the experimental group (n= 45) treated with FNS. Surgical outcomes, including incision size, blood loss, operation time, fluoroscopy frequency, and fracture healing time, were compared. Postoperative complication rates, reoperation rates, Harris scores, and visual analogue scale (VAS) scores were also assessed.
The experimental group demonstrated significantly reduced incision length, blood loss, operation time, and fluoroscopy frequency compared to the control group (P< 0.01). No significant differences were observed in fracture healing time, Garden classification, or fracture reduction outcomes between the two groups (P> 0.05). At 6 months post-treatment, both groups showed significant improvements in Harris scores and VAS scores compared to pre-treatment (P< 0.05), with no significant differences between the groups (P> 0.05). The rates of internal fixation failure, nonunion, and avascular necrosis of the femoral head, as well as overall incidence of postoperative complications and reoperation rates, showed no significant differences between the two groups (P> 0.05).
Both DHS with anti-rotation screw and FNS internal fixation demonstrated comparable efficacy and safety profiles in the treatment of Garden II-IV type femoral neck fractures. The experimental group showed advantages in terms of reduced incision length, blood loss, operation time, and fluoroscopy frequency, while maintaining similar clinical outcomes and complication rates.
股骨颈骨折是指股骨头至股骨颈基底之间的骨折，常见于老年人群。随着社会老龄化的发展，股骨颈骨折的发病率稳步上升，成为一个亟待解决的全球性问题。
比较动力髋螺钉（DHS）加防旋螺钉与股骨颈系统（FNS）内固定治疗 Garden II-IV 型股骨颈骨折的疗效和安全性。
将 90 例 Garden II-IV 型股骨颈骨折患者随机分为对照组（n=45）和实验组（n=45），分别采用 DHS 加防旋螺钉和 FNS 内固定治疗。比较两组手术切口大小、术中出血量、手术时间、透视次数、骨折愈合时间等手术结果；比较两组术后并发症发生率、再次手术率、Harris 评分和视觉模拟评分（VAS）。
实验组的手术切口长度、术中出血量、手术时间和透视次数明显小于对照组（P<0.01）。两组骨折愈合时间、Garden 分型和骨折复位结果差异无统计学意义（P>0.05）。治疗后 6 个月，两组 Harris 评分和 VAS 评分均较治疗前明显改善（P<0.05），组间差异无统计学意义（P>0.05）。两组内固定失败、骨不连、股骨头缺血性坏死发生率以及术后并发症总发生率和再次手术率差异无统计学意义（P>0.05）。
DHS 加防旋螺钉和 FNS 内固定治疗 Garden II-IV 型股骨颈骨折的疗效和安全性相当。实验组在手术切口长度、术中出血量、手术时间和透视次数方面具有优势，同时保持相似的临床疗效和并发症发生率。
