Lalueza-Andreu P, Martínez-García Á, Checa-Betegón P, García-Coiradas J, Valle-Cruz J A, Marco-Martínez F
Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, España.
Cirugía Ortopédica y Traumatología, Unidad de Traumatología Compleja, Hospital Clínico San Carlos, Madrid, España.
Rev Esp Cir Ortop Traumatol. 2024 Oct 1. doi: 10.1016/j.recot.2024.09.008.
The objective of this study is to compare the outcomes of using the Femoral Neck System (FNS) (DePuy Synthes®) versus the use of cannulated screws (CS) in the surgical treatment of non-displaced subcapital hip fractures.
A retrospective cohort study was conducted on non-displaced subcapital hip fractures treated with CS or FNS between 2020 and 2023, with a minimum follow-up of one year. A total of 28 patients were included, 14 treated with CS and 14 with FNS. Demographic, radiological, clinical, and functional variables were analyzed.
In the CS group, 64% were male, with a mean age of 66.5 years (SD 14.9) and an average follow-up of 22 months (range, 12-36 months). In the FNS group, 57% were male, with a median age of 60.8 years (SD 13.78) and an average follow-up of 16 months (range, 12-24 months). Regarding functional outcomes, no significant differences were found between FNS and CS in the Harris scale: 94.21±11.55 for FNS and 96.50±6.9 for CS (p=0.618). The total postoperative complications (FNS/CS) were 7.1% versus 43%, and implant failure with conversion to total hip replacement was 0% versus 43%, both significantly higher in the CS group (p=0.047; p=0.016, respectively). The FNS also presented a lower rate of avascular necrosis (0% versus 11.1%, p=0.391) and nonunion (0% versus 20%, p=0.163), although these differences did not reach statistical significance.
Although both treatment methods, cannulated screws and the FNS, showed similar short-term functional outcomes in the management of undisplaced subcapital femoral fractures, the FNS demonstrated a significantly lower rate of complications and reoperations. These results suggest that the FNS could be considered a safer and more effective option compared to cannulated screws.
本研究的目的是比较使用股骨颈系统（FNS）（DePuy Synthes®）与使用空心钉（CS）手术治疗无移位的股骨颈骨折的疗效。
对2020年至2023年期间接受CS或FNS治疗的无移位股骨颈骨折患者进行回顾性队列研究，最短随访1年。共纳入28例患者，14例接受CS治疗，14例接受FNS治疗。分析人口统计学、放射学、临床和功能变量。
在CS组中，64%为男性，平均年龄66.5岁（标准差14.9），平均随访22个月（范围12 - 36个月）。在FNS组中，57%为男性，中位年龄60.8岁（标准差13.78），平均随访16个月（范围12 - 24个月）。关于功能结局，FNS和CS在Harris评分上无显著差异：FNS为94.21±11.55，CS为96.50±6.9（p = 0.618）。术后总并发症（FNS/CS）分别为7.1%和43%，植入物失败并转换为全髋关节置换的比例分别为0%和43%，CS组均显著更高（分别为p = 0.047；p = 0.016）。FNS的股骨头缺血坏死率（0%对11.1%，p = 0.391）和骨不连率（0%对20%，p = 0.163）也较低，尽管这些差异未达到统计学意义。
尽管空心钉和FNS这两种治疗方法在治疗无移位股骨颈骨折时短期功能结局相似，但FNS的并发症和再次手术率显著更低。这些结果表明，与空心钉相比，FNS可能是一种更安全、更有效的选择。
