PDF(Pubmed)
Abstract：
Introduction: Basicervical femoral neck fracture (FNF) is an uncommon type of femoral neck fracture and is associated with an increased risk of fixation failure due to its inherent instability. The purpose of this study was to compare the surgical parameters and reoperation rate between the use of a multiple cannulated screw (MCS) and fixed angle device (FAD) in treating basicervical FNFs. Methods: We retrospectively reviewed the records of 885 patients who underwent internal fixation between May 2004 and August 2019 to determine basicervical FNF with at least 12 months of follow-up. Among the identified 77 patients with basicervical FNF, 17 patients who underwent multiple cannulated screw (MCS) fixation and 36 patients who underwent fixed angle device (FAD) fixation were included. We compared the rates of fracture-site collapse and reoperations according to the fixation device. Results: Among the 53 patients with basicervical FNF, 13 patients (24.5%) sustained surgical complications (8 collapses of fracture site and 5 reoperations). The reoperation rate in the MCS group was significantly higher than that in the FAD group (23.5% vs. 2.8%, p = 0.016), without any significant difference in the collapse of the fracture site (11.8% vs. 16.7%, p = 0.642). Conclusions: Although basicervical FNF was rare among hip fractures, fracture site collapse was prevalent and prone to fixation failure. Surgeons should keep this in mind, and consider FAD for basicervical FNF.
摘要：
简介：股骨颈基颈骨折（FNF）是一种罕见的股骨颈骨折类型，由于其固有的不稳定性，会增加固定失败的风险。这项研究的目的是比较使用多空心螺钉（MCS）和固定角度装置（FAD）治疗基础宫颈FNFs的手术参数和再手术率。方法：我们回顾性回顾了2004年5月至2019年8月接受内固定的885例患者的记录，以确定至少12个月的随访。在确定的77例基础宫颈FNF患者中，包括17例接受多空心螺钉（MCS）固定的患者和36例接受固定角度装置（FAD）固定的患者。我们根据固定装置比较了骨折部位塌陷和再次手术的发生率。结果：在53例基础宫颈FNF患者中，13例（24.5％）持续手术并发症（8例骨折部位塌陷，5例再次手术）。MCS组的再手术率明显高于FAD组（23.5%vs.2.8%，p=0.016),骨折部位塌陷无任何显著差异(11.8%与16.7%,p=0.642)。结论：虽然基底颈FNF在髋部骨折中很少见，骨折部位塌陷普遍存在，容易发生内固定失败。外科医生应该记住这一点，并考虑将FAD用于基础宫颈FNF。
