股骨颈系统固定Pauwels III型股骨颈骨折△

Femoral neck system for internal fixation of Pauwels type III femoral neck fracture

摘要:

［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 Pauwels III 型股骨颈骨折，能明显降低术后并发症，获得满意临床效果。

Abstract:

[Objective] To evaluate the clinical outcomes of femoral neck system (FNS) in the fixation of Pauwels type III femoral neck fractures. [Methods] From March 2020 to August 2020, 23 patients underwent reduction and internal fixation with FNS for Pauwels type III femoral 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 resumed- full 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 in- dex on the anteroposterior and lateral radiographs. Femoral neck shortening increased significantly over time (P＜0.05) , with shortening oc- currence 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 Pauwelstype III femoral neck fracture does significantly reduce postoperative complications and achieve satisfactory clinical results.