股骨颈系统固定PauwelsⅢ型股骨颈骨折

Femoral neck system for internal fixation of Pauwels typeⅢfemoral neck fracture

[目的]评价股骨颈系统(femoral neck system,FNS)固定Pauwels Ⅲ型股骨颈骨折的临床效果。[方法]2020年3月—2020年8月,采用FNS固定Pauwels Ⅲ型股骨颈骨折23例。评价其近期临床与影像结果。[结果]所有患者顺利完成手术,无神经、血管损伤等并发症。随访时间平均(17.22±1.55)个月,随时间推移,Harris评分、髋伸-屈ROM及髋内-外旋ROM均显著增加(P<0.05)。其中,22例完全负重活动时间为3~6个月,平均(4.42±0.95)个月,另1例患者至末次随访时仍不能完全负重。影像方面,依据术后正侧位X线片Garden指数,所有患者均获满意骨折复位。随时间推移,股骨颈短缩显著增加(P<0.05),短缩发生率为5/23(21.74%)。至末次随访,除1例外,其余患者均骨折愈合。[结论]股骨颈系统固定PauwelsⅢ型股骨颈骨折,能明显降低术后并发症,获得满意临床效果。

[Objective]To evaluate the clinical outcomes of femoral neck system(FNS)in the fixation of Pauwels typeⅢfemoral neck fractures.[Methods]From March 2020 to August 2020,23 patients underwent reduction and internal fixation with FNS for Pauwels typeⅢfemoral neck fracture.The clinical and imaging consequences were evaluated.[Results]All patients were successfully operated on without neurovascular injury and other complications.During follow-up period lasted for(17.22±1.55)months,the Harris score,extension-flexion range of motion(ROM)and internal-external rotation ROM increased significantly over time(P<0.05).Among them,22 patients resumedfull weight-bearing activity in 3~6 months,with an average of(4.42±0.95)months,while another patient who remained unable to walk with full weight-bearing until the last follow-up.Radiographically,all patients achieved satisfactory fracture reduction according to Garden index on the anteroposterior and lateral radiographs.Femoral neck shortening increased significantly over time(P<0.05),with shortening occurrence of 5/23(21.74%).By the latest follow-up,all patients got fracture healing except 1 case.[Conclusion]This FNS used for fixation of PauwelstypeⅢfemoral neck fracture does significantly reduce postoperative complications and achieve satisfactory clinical results.