Multiple cannulated screw fixation of femoral neck fractures with comminution in young- and middle-aged patients.
Multiple cannulated screw fixation of femoral neck fractures with comminution in young- and middle-aged patients.
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多头空心螺钉内固定治疗中青年股骨颈粉碎性骨折
DOI：
10.1186/s13018-022-03157-7
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发表时间：
2022-05-18
影响因子：
2.6
通讯作者：
中科院分区：
文献类型：
--
作者：
探讨股骨颈骨折（FNF）患者空心螺钉（CSF）固定后粉碎性骨折的分布及其影响。从2019年1月至2020年6月，本研究共纳入了473例接受CSF治疗的23-65岁FNF患者。根据皮质粉碎的位置，将FNF患者分为两组：粉碎组（前部粉碎、后部粉碎、上级粉碎、下层粉碎、多处粉碎）或无粉碎组。术后随访1年，记录术后并发症发生率、生活质量和功能结局。移位型FNF的粉碎发生率（86.8%）高于非移位型FNF（8.9%），且粉碎发生率与Pauwels分级密切相关（3.2% vs53.5% vs83.9%，P < 0.05）。股骨头坏死的发病率股骨头坏死11.3%对2.9%，P < 0.05（7.5%vs1.7%，P < 0.05），股骨颈短缩（21.6%vs13.4%，P < 0.05）和内固定失败FNF合并粉碎性骨折，尤其是合并多发粉碎性骨折，FNF的血清TNF-α水平（11.8%vs2.9%，P < 0.05）明显高于无粉碎性骨折。有粉碎性骨折的FNF患者Harris髋关节评分（85.6 ± 15.6vs91.3 ± 10.8，P < 0.05）和EuroQol五维量表（EQ-5D）评分（0.85 ± 0.17vs0.91 ± 0.18，P < 0.05）与无粉碎性骨折的FNF患者比较，差异有统计学意义。术后1年时两组的视觉模拟量表评分（VAS，1.46 ± 2.49 vs 1.13 ± 1.80，P > 0.05）无显著差异。粉碎是接受CSF治疗的年轻和中年移位和Pauwels III型FNF患者术后并发症的危险因素。这可能会影响髋关节功能的恢复，从而影响生活质量。需要更全面的研究设计、更大样本和长期随访进行进一步评价。
To investigate the distribution and influence of comminution in femoral neck fracture (FNF) patients after cannulated screw fixation (CSF). From January 2019 to June 2020, a total of 473 patients aged 23–65 years with FNF treated by CSF were included in the present study. Based on location of the cortical comminution, FNF patients were assigned to two groups: the comminution group (anterior comminution, posterior comminution, superior comminution, inferior comminution, multiple comminutions) or the without comminution group. The incidence of postoperative complications, quality of life and functional outcomes was recorded at 1-year follow-up. Comminution was more likely to appear in displaced FNF patients (86.8%) compared with non-displaced FNF patients (8.9%), and the rate of comminution was closely associated with Pauwels classification (3.2% vs 53.5% vs 83.9%, P < 0.05). The incidence of osteonecrosis of the femoral head (ONFH, 11.3% vs 2.9%, P < 0.05), nonunion (7.5% vs 1.7%, P < 0.05), femoral neck shortening (21.6% vs 13.4%, P < 0.05) and internal fixation failure (11.8% vs 2.9%, P < 0.05) was significantly higher in FNF patients with comminutions, especially with multiple comminutions, than those without. Furthermore, there was a significant difference in the Harris hip score (HHS, 85.6 ± 15.6 vs 91.3 ± 10.8, P < 0.05) and EuroQol five dimensions questionnaire (EQ-5D, 0.85 ± 0.17 vs 0.91 ± 0.18, P < 0.05) between FNF patients with comminution and those without. There was no significant difference in Visual analogue scale scores (VAS, 1.46 ± 2.49 vs 1.13 ± 1.80, P > 0.05) between two groups at 1 year post-surgery. Comminution is a risk factor for postoperative complications in young- and middle-aged patients with displaced and Pauwels type III FNF who undergo CSF. This can influence the recovery of hip function, thereby impacting quality of life. Further evaluation with a more comprehensive study design, larger sample and long-term follow-up is needed.
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影响因子：
5.3
作者：
Liporace, Frank;Gaines, Robert;Haidukewych, George J.
通讯作者：
Haidukewych, George J.
影响因子：
3.3
作者：
Brooks, R
通讯作者：
Brooks, R
影响因子：
2.3
作者：
Collinge, Cory A.;Mir, Hassan;Reddix, Robert
通讯作者：
Reddix, Robert
影响因子：
1.8
作者：
Lee, K A;Kieckhefer, G M
通讯作者：
Kieckhefer, G M
DOI：
10.1302/0301-620x.46b4.648
发表时间：
1964-01-01
影响因子：
--
作者：
BROWN, JT;ABRAMI, G
通讯作者：
ABRAMI, G