Age is Not the Most Important Factor in the Prognosis of Femoral Neck Fracture: An Analysis of Long-Term Clinical Follow-Up.

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Abstract

[Indexed for MEDLINE] 17. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Jun 15;37(6):681-687. doi: 10.7507/1002-1892.202303044. [Treatment of femoral neck fractures with closed reduction assisted by joystick technique and cannulated screw fixation]. [Article in Chinese; Abstract available in Chinese from the publisher] Wang L(1), Zhang J(1), Liu X(2), Wu Z(1), Wu A(1). Author information: (1)The Fourth Department of Trauma Orthopaedics, the Second Hospital of Tangshan, Tangshan Hebei, 063000, P. R. China. (2)Department of Rehabilitation Medicine, Tangshan Workers' Hospital, Tangshan Hebei, 063000, P. R. China. OBJECTIVE: To investigate the effectiveness of joystick technique assisted closed reduction and cannulated screw fixation in the treatment of femoral neck fracture. METHODS: Seventy-four patients with fresh femoral neck fractures who met the selection criteria between April 2017 and December 2018 were selected and divided into observation group (36 cases with closed reduction assisted by joystick technique) and control group (38 cases with closed manual reduction). There was no significant difference in gender, age, fracture side, cause of injury, Garden classification, Pauwels classification, time from injury to operation, and complications (except for hypertension) between the two groups ( P>0.05). The operation time, intraoperative infusion volume, complications, and femoral neck shortening were recorded and compared between the two groups. Garden reduction index was used to evaluate the effect of fracture reduction, and score of fracture reduction (SFR) was designed and was used to evaluate the subtle reduction effect of joystick technique. RESULTS: The operation was successfully completed in both groups. There was no significant difference in operation time and intraoperative infusion volume between the two groups ( P>0.05). All patients were followed up 17-38 months, with an average of 27.7 months. Two patients in the observation group received joint replacement due to failure of internal fixation during the follow-up, and the other patients had fracture healing. Within 1 week after operation, the Garden reduxtion index of the observation group was better than the control group; the SFR score of the observation group was also higher than that of the control group; the proportion of femoral neck shortening within 1 week after operation and at 1 year after operation in the observation group were lower than those in the control group. The differences of the above indexes between the two groups were significant ( P0.05）。记录并比较两组手术时间、术中输液量、并发症发生情况及股骨颈短缩情况。采用Garden复位指数评价骨折复位效果；为体现撬拨技术起到的细微复位效果，设计股骨颈复位评分（score of fracture reduction，SFR）并进行评价。. 结果: 两组患者手术均顺利完成。两组手术时间、术中输液量比较差异均无统计学意义（ P>0.05）。所有患者均获随访，随访时间17～38个月，平均27.7个月。观察组中2例患者随访期间发生内固定失效而接受关节置换术，其余患者骨折均愈合。术后1周内观察组Garden复位指数优于对照组；观察组SFR评分亦高于对照组；观察组术后1周内和最终（术后1年）股骨颈短缩发生率均低于对照组；以上指标两组间比较差异均有统计学意义（ P