Jia Mingwang, Ding Chenning, Zhao Xin, Han Xing, Zhang Jiahui, Sang Xiguang
Department of Emergency Surgery and Orthopaedic Surgery, Qilu Hospital of Shandong University, No. 107, West Wenhua Road, Jinan, Shandong, 250012, PR China.
Cheeloo College of Medicine, Shandong University, No. 44, West Wenhua Road, Jinan, Shandong, 250012, PR China.
J Orthop Surg Res. 2024 Dec 19;19(1):842. doi: 10.1186/s13018-024-05327-1.
Femoral neck fractures (FNFs) are a common orthopedic type, and there are many treatment methods for it, and cannulated screw internal fixation is currently one of the main treatment methods. The choice of fully threaded cannulated screw (FCS) or partially threaded cannulated screw (PCS) remains controversial. Therefore, we performed this meta-analysis to evaluate the outcomes of FCS and PCS in the treatment of FNF.
Articles published before 29 April, 2024 were selected from PubMed, Embase, the Cochrane Library, and CNKI, using the PRISMA guidelines. Two independent reviewers searched and assessed the literature. The PICOS criteria were used to ensure that the included studies met the inclusion criteria. We used RevMan 5.3. Software to perform analysis.
Compared with the PCS group, the FCS group had a lower femoral head necrosis rate (OR 0.60, 95% CI 0.37-0.98, P = 0.04), lower internal fixation failure rate (OR 0.37, 95% CI 0.22-0.62, P = 0.0002) and lower femoral neck shortening rate (OR 0.27, 95% CI 0.19-0.40, P < 0.00001). There was no statistically significant difference between the two groups in terms of the Harris hip score or nonunion rate.
The results of this meta-analysis revealed that compared with PCS, FCS had a lower incidence of postoperative complications and better postoperative outcomes in the treatment of FNF. Therefore, we believe that FCS may be a more effective treatment for FNF.
股骨颈骨折（FNFs）是一种常见的骨科疾病类型，针对其有多种治疗方法，空心钉内固定是目前主要的治疗方法之一。全螺纹空心钉（FCS）与部分螺纹空心钉（PCS）的选择仍存在争议。因此，我们进行了这项荟萃分析，以评估FCS和PCS治疗FNF的效果。
按照PRISMA指南，从PubMed、Embase、Cochrane图书馆和中国知网中检索2024年4月29日前发表的文章。两名独立的评审员对文献进行检索和评估。采用PICOS标准确保纳入的研究符合纳入标准。我们使用RevMan 5.3软件进行分析。
与PCS组相比，FCS组的股骨头坏死率更低（OR 0.60，95%CI 0.37 - 0.98，P = 0.04），内固定失败率更低（OR 0.37，95%CI 0.22 - 0.62，P = 0.0002），股骨颈缩短率更低（OR 0.27，95%CI 0.19 - 0.40，P < 0.00001）。两组在Harris髋关节评分或骨不连发生率方面无统计学显著差异。
这项荟萃分析的结果显示，与PCS相比，FCS治疗FNF的术后并发症发生率更低，术后效果更好。因此，我们认为FCS可能是治疗FNF更有效的方法。
