FNS与THA在老年股骨颈骨折治疗中的疗效比较

Comparison of FNS and Total Hip Replacement in the Treatment of Femoral Neck Fracture in Elderly Patients

摘要: 目的：比较股骨颈动力交叉钉系统(FNS)与全髋关节置换治疗老年股骨颈骨折的临床疗效。方法：回顾性分析自2022-01至2023-06期间采用FNS内固定与全髋关节置换(THA)治疗的42例老年股骨颈骨折，根据手术方式不同分为FNS组和THA组。比较两组手术时间、术中出血量、住院时间、术后Harris髋关节功能评分(HHS)及术后并发症发生情况。结果：FNS组的THA组的手术时间、住院时间、术后Harris髋关节功能评分差异无统计学意义(P > 0.05)，FNS组术中出血量少于THA组，差异有统计学意义(P < 0.05)。FNS组有1例发生股骨头缺血坏死，THA组1例发生切口感染，1例出现下肢深静脉血栓，两组间并发症发生率差异无统计学意义(P > 0.05)。结论：FNS系统与全髋关节置换治疗老年股骨颈骨折在手术时长、术后髋关节功能恢复及并发症等方面无明显差异，FNS内固定术中出血量较少，是一种可行的治疗老年股骨颈骨折的方式。

Abstract: Objective: To compare the clinical effect of femoral neck system (FNS) and empty total hip replacement in the treatment of elderly femoral neck fractures. Methods: 42 elderly patients with femoral neck fractures treated by FNS internal fixation and total hip replacement (THA) from 2022-01 to 2023-01 were retrospectively analyzed and divided into FNS group and THA group according to different surgical methods. Operation time, intraoperative blood loss, length of hospital stay, Harris hip function score (HHS) and postoperative complications were compared between the two groups. Results: There was no significant difference in operative time, hospital stay and Harris hip function score between FNS group and THA group (P > 0.05). Intraoperative blood loss in FNS group was less than that in THA group (P < 0.05). There was 1 case of avonecrosis of the femoral head in FNS group, 1 case of incision infection in THA group, and 1 case of deep vein thrombosis in lower extremity. There was no significant difference in the incidence of complications between the two groups (P > 0.05). Conclusion: There is no significant difference between FNS system and total hip replacement in the treatment of elderly femoral neck fractures in terms of operation duration, postoperative hip functional recovery and complications. FNS internal fixation has less blood loss, and has better anti-shear, anti-rotation and anti-slip effects.