股骨颈系统固定治疗股骨颈骨折的近期疗效分析

Fixation with Femoral Neck System for femoral neck fractures:short-term therapeutic outcomes

目的:探讨股骨颈系统(FNS)固定治疗股骨颈骨折的近期疗效。方法:回顾性分析2019年1月至12月期间安徽医科大学第二附属医院创伤骨科收治的16例股骨颈骨折患者资料。男6例,女10例;年龄为24~69岁,平均47.5岁。骨折按Garden分型:Ⅱ型3例,Ⅲ型7例,Ⅳ型6例。16例患者均采用FNS固定治疗。记录患者的手术时间、术中透视次数、术中出血量、术后骨折复位质量、住院时间、骨折愈合时间、末次随访时疗效及并发症发生情况等。结果:16例患者术后获5~16个月(平均9.3个月)随访。术后骨折复位质量根据Garden指数评定:16例患者骨折复位均满意。本组患者的手术时间为25~115 min,平均41.5 min;术中透视次数为14~47次,平均26次;术中出血量为35~210 mL,平均76 mL;住院时间为3~9 d,平均4.6 d;骨折愈合时间为3~6个月,平均4.5个月。末次随访时根据髋关节Harris评分系统评定患髋功能:优10例,良5例,可1例。随访期间无一例患者发生感染、内固定物松动等并发症。结论:FNS固定治疗股骨颈骨折操作简单,可以通过单一微创切口置入股骨颈动力棒、外侧钢板、锁定螺钉及抗旋螺钉,固定可靠,对外侧肌肉软组织的激惹小,近期疗效良好。

Objective To explore the short-term therapeutic outcomes of femoral neck fractures fixated by Femoral Neck System(FNS).Methods A retrospective analysis was conducted of the 16 patients with femoral neck fracture who had been admitted to the Department of Traumatology&Orthopedics,The Second Affiliated Hospital to Anhui Medical University from January to December 2019.They were 6 males and 10 females,aged from 24 to 69 years(average,47.5 years).According to the Garden Classification,there were 3 cases of typeⅡ,7 cases of typeⅢ,and 6 cases of typeⅣ.All the 16 patients were fixated with FNS.Recorded were operation time,frequency of intraoperative fluoroscopy,intraoperative blood loss,quality of postoperative fracture reduction,hospital stay,fracture healing time,and efficacy and complications at the last follow-up.Results The 16 patients were followed up for 5 to 16 months after operation(average,9.3 months).According to the Garden indexes,fracture reduction was evaluated as satisfactory in all the 16 patients.The operation time in this group ranged from 25 to 115 min with an average of 41.5 min,the frequency of intraoperative fluoroscopy from 14 to 47 times with an average of 26 times,the intraoperative blood loss from 35 to 210 mL with an average of 76 mL,the hospital stay from 3 to 9 days with an average of 4.6 days,and the fracture healing time from 3 to 6 months with an average of 4.5 months.By the Harris hip scores at the last follow-up,the function of the affected hip was rated as excellent in 10 cases,good in 5 and fair in one.Follow-ups revealed no complications like infection or implant loosening.Conclusions The FNS is a new type of simple,reliable,safe and minimally invasive internal fixation for the treatment of femoral neck fractures.The plate,bolt,anti-rotation screws and locking screws in FNS can be inserted through a single minimally invasive incision,leading to reliable fixation,limited irritation to the lateral muscular soft tissues,and fine short-term outcomes.