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采用股骨颈系统(FNS)内固定治疗囊内股骨颈骨折的疗效。

Outcomes of internal fixation with Femoral Neck System (FNS) for intracapsular femoral neck fractures.

作者信息

Tarrant Seth A, Mitchell Brendan P, Blankespoor Michael G, Littell Zane D, Zackula Rosalee E, Lais Randall L, Dart Bradley R

机构信息

University of Kansas School of Medicine-Wichita (KU SOM-Wichita), Wichita, KS.

Department of Orthopaedic Surgery, KU SOM-Wichita, Wichita, KS.

出版信息

OTA Int. 2024 Sep 18;7(4):e346. doi: 10.1097/OI9.0000000000000346. eCollection 2024 Dec.

Abstract

BACKGROUND

Internal fixation of hip fractures is associated with high reoperation rates. This study investigated the reoperation rates after internal fixation with the femoral neck system (FNS).

MATERIALS AND METHODS

A single-institution cohort study was conducted on patients aged 18 years or older who sustained intracapsular femoral neck fractures and underwent internal fixation with a fixed-angle implant. Surgeons, patients, and investigators were not blinded. The primary outcome was any hip reoperation at the final follow-up. Secondary outcomes were to characterize a cohort of patients regarding demographics, fracture classification, intraoperative findings, postoperative fracture complications and union rates, and postoperative pain.

RESULTS

This study found that internal fixation with FNS for intracapsular femoral neck fractures was associated with a 23% rate of revision surgery. Of the initial 94 patients who received FNS internal fixation, 44 patients were included for analysis; of those, 10 patients underwent revision surgery. Patients had a 22% rate of in-hospital medical adverse events with a 30-day readmission rate of 9%. Increasing body mass index was associated with increased revision rates ( = 0.037). Patients who sustained displaced femoral neck fractures had a significant decrease in SF-12 Mental Health Composite, SF-12 Physical Health Composite, and quality-of-life subscale scores.

CONCLUSIONS

The FNS is a viable alternative for internal fixation of intracapsular femoral neck fractures. The observed rate of revision after internal fixation was comparable with previously published outcomes following fixation with cannulated screws and sliding hip screws.

LEVEL OF EVIDENCE

Level IV, Therapeutic Study.

摘要

背景

髋部骨折内固定术后再次手术率较高。本研究调查了使用股骨颈系统(FNS)内固定后的再次手术率。

材料与方法

对年龄在18岁及以上、发生囊内股骨颈骨折并接受角稳定型植入物内固定的患者进行了单机构队列研究。外科医生、患者和研究人员均未设盲。主要结局是末次随访时的任何髋部再次手术。次要结局是描述一组患者的人口统计学特征、骨折分类、术中发现、术后骨折并发症和愈合率以及术后疼痛情况。

结果

本研究发现,使用FNS对囊内股骨颈骨折进行内固定后,翻修手术率为23%。在最初接受FNS内固定的94例患者中,44例纳入分析;其中10例接受了翻修手术。患者的院内医疗不良事件发生率为22%,30天再入院率为9%。体重指数增加与翻修率增加相关(P = 0.037)。发生股骨颈移位骨折的患者,其SF-12心理健康综合评分、SF-12身体健康综合评分和生活质量子量表评分显著降低。

结论

FNS是囊内股骨颈骨折内固定的一种可行替代方法。观察到的内固定后翻修率与先前发表的空心钉和动力髋螺钉固定后的结果相当。

证据级别

四级,治疗性研究。

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