Citation: | QIN Qi, Alimujiang·YUSUFU, LIU Yuzhe, YIN Can, CUI Sha, RAN Jian. Efficacy of femoral neck system and cannulated screw in treatment of femoral neck fracture: a meta-analysis[J]. Journal of Clinical Medicine in Practice, 2024, 28(2): 63-72. DOI: 10.7619/jcmp.20231674 |
To evaluate the efficacy of femoral neck system (FNS) and cannulated screw (CS) in the treatment of femoral neck fracture in adults during perioperative and conjunctional periods.
By searching CNKI, Wanfang, VIP, CBM, PubMed, Embase and Cochrane databases, relevant literatures on the efficacy comparison of the two internal fixation regimens were collected. Review Manager 5.3 software was used to conduct a meta-analysis of the literature finally included in the study.
A total of 24 retrospective cohort studies were included in this study, with a total of 1 661 participants, including 783 participants in the FNS group (FNS treatment) and 878 participants in the CS group (CS treatment). In the FNS group, intraoperative fluoroscopy times (MD=-9.69, 95%CI, -11.27 to -8.11, P < 0.01), complete weight-bearing time (MD=-1.69, 95%CI, -2.88 to -0.50, P < 0.01), fracture healing time (MD=-1.15, 95%CI, -1.57 to -0.73, P < 0.01), Harris score at last follow-up (MD=-1.5, 95%CI, 2.30 to 4.59, P < 0.01) and femoral head necrosis rate (OR=0.48, 95%CI, 0.26 to 0.91, P=0.02) were superior in the CS group; however, intraoperative blood loss (MD=17.72, 95%CI, 9.88 to 25.55, P < 0.01) and incision length (MD=0.39, 95%CI, 0.04 to 0.73, P=0.03) in the FNS group were higher than those in the CS group. There were no significant differences between the two groups in terms of operation time (MD=-3.78, 95%CI, -7.95 to 0.39, P=0.08) and total hospitalization days (RR=-0.14, 95%CI, -0.43 to 0.14, P=0.32).
FNS in the treatment of adult femoral neck fractures has the advantages of less intraoperative fluoroscopy, earlier complete weight-bearing time, faster fracture healing and higher hip Harris score, but compared with CS, it has more intraoperative blood loss and larger incision area.
[1] |
战红旗, 马剑雄, 崔爽爽, 等. 三维测量嵌插型股骨颈骨折后倾角与股骨头坏死的相关性[J]. 中国组织工程研究, 2023, 27(36): 5747-5752. doi: 10.12307/2023.758
|
[2] |
王辉. 青壮年股骨颈骨折的治疗进展[J]. 中国医学创新, 2022, 19(19): 184-188. doi: 10.3969/j.issn.1674-4985.2022.19.043
|
[3] |
马贤明, 黄文良, 张勇, 等. 青年股骨颈骨折外科手术治疗的研究进展[J]. 中国医药导报, 2021, 18(36): 61-64. doi: 10.3969/j.issn.1673-7210.2021.36.yycyzx202136014
|
[4] |
中华医学会骨科学分会创伤骨科学组, 中国医师协会骨科医师分会创伤专家工作委员会. 成人股骨颈骨折诊治指南[J]. 中华创伤骨科杂志, 2018, 20(11): 921-928. doi: 10.3760/cma.j.issn.1671-7600.2018.11.001
|
[5] |
范智荣, 苏海涛, 周霖, 等. 新型股骨颈内固定系统治疗不稳定性股骨颈骨折的有限元分析[J]. 中国组织工程研究, 2021, 25(15): 2321-2328. doi: 10.3969/j.issn.2095-4344.3810
|
[6] |
汪洋. Cochrane偏倚风险评估工具简介[J]. 中国全科医学, 2019, 22(11): 1322.
|
[7] |
STANG A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses[J]. Eur J Epidemiol, 2010, 25(9): 603-605. doi: 10.1007/s10654-010-9491-z
|
[8] |
汪天豪, 梁晓龙, 郑恺, 等. 股骨颈动力交叉钉系统与空心加压螺钉治疗老年股骨颈骨折短期随访的对比[J]. 中国组织工程研究, 2023, 27(36): 5828-5833. doi: 10.12307/2023.730
|
[9] |
翁友林, 李祖涛, 蔡昱, 等. 股骨颈动力交叉钉系统和空心钉治疗Pauwels Ⅲ型股骨颈骨折近期疗效[J]. 实用医学杂志, 2022, 38(23): 2962-2967. doi: 10.3969/j.issn.1006-5725.2022.23.013
|
[10] |
吴涛华, 刘清平, 阮康明. 股骨颈动力交叉钉系统与倒三角空心钉治疗青壮年股骨颈骨折的近期疗效比较[J]. 实用中西医结合临床, 2022, 22(16): 40-43.
|
[11] |
朱轶, 刘苏, 张金坤, 等. 股骨颈动力交叉钉系统与3枚空心钉内固定治疗股骨颈骨折的短期疗效比较[J]. 中国骨与关节损伤杂志, 2022, 37(6): 605-608.
|
[12] |
周雪锋. 股骨颈动力交叉钉系统与空心螺钉治疗青年GardenⅢ、Ⅳ型股骨颈骨折的对比研究[D]. 芜湖: 皖南医学院, 2022.
|
[13] |
葛双雷, 王雪飞, 胡国东, 等. 股骨颈动力交叉钉系统治疗中青年PauwelsⅡ型股骨颈骨折临床价值[J]. 中国骨与关节杂志, 2022, 11(4): 255-260. doi: 10.3969/j.issn.2095-252X.2022.04.004
|
[14] |
赵耀, 许新忠, 程文丹, 等. 股骨颈动力交叉钉系统内固定治疗股骨颈骨折的早期疗效分析[J]. 中国骨与关节损伤杂志, 2022, 37(4): 389-391.
|
[15] |
严才平, 王星宽, 向超, 等. 股骨颈动力交叉钉系统与空心加压螺钉治疗中青年股骨颈骨折的疗效比较[J]. 中国修复重建外科杂志, 2021, 35(10): 1286-1292.
|
[16] |
杨亚军, 马涛, 张小钰, 等. 股骨颈动力交叉钉系统治疗股骨颈骨折近期疗效[J]. 中国修复重建外科杂志, 2021, 35(5): 539-543.
|
[17] |
黄小东, 陶岳峰, 朱炳斌, 等. 三枚空心钉与动力交叉钉系统固定治疗股骨颈骨折的临床疗效对比[J]. 中国医刊, 2023, 58(2): 179-182. doi: 10.3969/j.issn.1008-1070.2023.02.017
|
[18] |
马贤明. FNS与CCS治疗中青年Garden Ⅲ型、Ⅳ型股骨颈骨折的短期疗效比较[D]. 遵义: 遵义医科大学, 2022.
|
[19] |
何昌军, 马腾, 任程, 等. 股骨颈动力交叉钉系统与空心螺钉治疗中青年股骨颈骨折的疗效比较[J]. 中华创伤杂志, 2022, 38(3): 253-259. doi: 10.3760/cma.j.cn501098-20211109-00579
|
[20] |
吴锦, 吴庆菊. 股骨颈动力交叉钉系统与倒三角空心钉治疗GardenⅢ、Ⅳ型股骨颈骨折的疗效[J]. 四川生理科学杂志, 2022, 44(11): 1950-1952, 2011.
|
[21] |
杨家赵, 周雪锋, 李黎, 等. 股骨颈动力交叉钉系统和倒三角空心钉治疗PauwelsⅢ型股骨颈骨折疗效比较[J]. 中国修复重建外科杂志, 2021, 35(9): 1111-1118.
|
[22] |
熊巍, 易敏, 龙成, 等. 股骨颈动力交叉钉系统与倒三角形空心螺钉固定治疗成人股骨颈骨折的疗效比较[J]. 中华创伤骨科杂志, 2021, 23(9): 748-753. doi: 10.3760/cma.j.cn115530-20210822-00388
|
[23] |
任程, 马腾, 李明, 等. 股骨颈动力交叉钉系统固定治疗中青年股骨颈骨折的近期疗效评价[J]. 中华创伤骨科杂志, 2021, 23(9): 769-774. doi: 10.3760/cma.j.cn115530-20210512-00233
|
[24] |
周东, 郭卫中, 吴舒婷, 等. 两种股骨颈骨折内固定方式的近期疗效比较[J]. 中国矫形外科杂志, 2022, 30(16): 1451-1456.
|
[25] |
HE C J, LU Y, WANG Q, et al. Comparison of the clinical efficacy of a femoral neck system versus cannulated screws in the treatment of femoral neck fracture in young adults[J]. BMC Musculoskelet Disord, 2021, 22(1): 994. doi: 10.1186/s12891-021-04888-0
|
[26] |
TANG Y F, ZHANG Z, WANG L M, et al. Femoral neck system versus inverted cannulated cancellous screw for the treatment of femoral neck fractures in adults: a preliminary comparative study[J]. J Orthop Surg Res, 2021, 16(1): 504. doi: 10.1186/s13018-021-02659-0
|
[27] |
HU H J, CHENG J B, FENG M L, et al. Clinical outcome of femoral neck system versus cannulated compression screws for fixation of femoral neck fracture in younger patients[J]. J Orthop Surg Res, 2021, 16(1): 370. doi: 10.1186/s13018-021-02517-z
|
[28] |
ZHOU X Q, LI Z Q, XU R J, et al. Comparison of early clinical results for femoral neck system and cannulated screws in the treatment of unstable femoral neck fractures[J]. Orthop Surg, 2021, 13(6): 1802-1809. doi: 10.1111/os.13098
|
[29] |
ZHANG Y Z, LIN Y, LI C, et al. A comparative analysis of femoral neck system and three cannulated screws fixation in the treatment of femoral neck fractures: a six-month follow-up[J]. Orthop Surg, 2022, 14(4): 686-693. doi: 10.1111/os.13235
|
[30] |
KENMEGNE G R, ZOU C, FANG Y, et al. Femoral neck fractures in non-geriatric patients: femoral neck system versus cannulated cancellous screw[J]. BMC Musculoskelet Disord, 2023, 24(1): 70. doi: 10.1186/s12891-023-06140-3
|
[31] |
HUANG S L, ZHANG Y Z, ZHANG X, et al. Comparison of femoral neck system and three cannulated cancellous screws in the treatment of vertical femoral neck fractures: clinical observation and finite element analysis[J]. Biomed Eng Online, 2023, 22(1): 20.
|
[32] |
ERIVAN R, SOLEIHAVOUP M, VILLATTE G, et al. Poor results of functional treatment of Garden-1 femoral neck fracture in dependent patients[J]. Orthop Traumatol Surg Res, 2020, 106(4): 601-605. doi: 10.1016/j.otsr.2019.09.027
|
[33] |
FLORSCHUTZ A V, LANGFORD J R, HAIDUKEWYCH G J, et al. Femoral neck fractures: current management[J]. J Orthop Trauma, 2015, 29(3): 121-129.
|
[34] |
ZHU Z D, XIAO C W, TAN B, et al. TiRobot-assisted percutaneous cannulated screw fixation in the treatment of femoral neck fractures: a minimum 2-year follow-up of 50 patients[J]. Orthop Surg, 2021, 13(1): 244-252.
|
[35] |
PANTELI M, RODHAM P, GIANNOUDIS P V. Biomechanical rationale for implant choices in femoral neck fracture fixation in the non-elderly[J]. Injury, 2015, 46(3): 445-452.
|
[36] |
王佳琦, 罗晓中, 童祎, 等. 机器人导航下3枚与4枚空心螺钉内固定治疗Pauwels Ⅲ型股骨颈骨折[J]. 中国组织工程研究, 2022, 26(15): 2352-2355.
|
[37] |
王子华, 赵德伟. 基于显微灌注和三维数字成像的股骨头血供解剖学研究为青壮年股骨颈骨折治疗策略带来的新启示[J]. 中华显微外科杂志, 2017, 40(5): 417-418.
|
[38] |
ZHAO D W, QIU X, WANG B J, et al. Epiphyseal arterial network and inferior retinacular artery seem critical to femoral head perfusion in adults with femoral neck fractures[J]. Clin Orthop Relat Res, 2017, 475(8): 2011-2023.
|
[39] |
杨通池, 胡居正, 王仁崇, 等. 股骨颈系统治疗成人Pauwels Ⅲ型股骨颈骨折的有限元分析[J]. 中国组织工程研究, 2022, 26(36): 5775-5780.
|
[40] |
杜兵, 马腾, 路遥, 等. 新型股骨颈内固定系统与3枚空心钉加内侧钢板固定青壮年Pauwels Ⅲ型股骨颈骨折的有限元分析[J]. 中华老年骨科与康复电子杂志, 2021, 7(6): 333-338.
|
[41] |
JUNG C H, CHA Y H, YOON H S, et al. Mechanical effects of surgical variations in the femoral neck system on Pauwels type Ⅲ femoral neck fracture: a finite element analysis[J]. Bone Joint Res, 2022, 11(2): 102-111.
|
[42] |
DUFFIN M, PILSON H T. Technologies for young femoral neck fracture fixation[J]. J Orthop Trauma, 2019, 33(Suppl 1): S20-S26.
|
[43] |
WANG X D, LAN H, LI K N. Treatment of Femoral Neck Fractures with Cannulated Screw Invasive Internal Fixation Assisted by Orthopaedic Surgery Robot Positioning System[J]. Orthop Surg, 2019, 11(5): 864-872.
|
[44] |
STASSEN R C, JEUKEN R M, BOONEN B, et al. First clinical results of 1-year follow-up of the femoral neck system for internal fixation of femoral neck fractures[J]. Arch Orthop Trauma Surg, 2022, 142(12): 3755-3763.
|
[45] |
冀家琛, 杨博, 王敏, 等. 股骨颈动力交叉钉系统治疗青壮年股骨颈骨折的研究进展[J]. 中国修复重建外科杂志, 2022, 36(11): 1434-1439.
|
[46] |
MA J X, KUANG M J, XING F, et al. Sliding hip screw versus cannulated cancellous screws for fixation of femoral neck fracture in adults: a systematic review[J]. Int J Surg, 2018, 52: 89-97.
|
[47] |
MEDDA S, SNOAP T, CARROLL E A. Treatment of young femoral neck fractures[J]. J Orthop Trauma, 2019, 33(Suppl 1): S1-S6.
|
[48] |
冀家琛, 陈豪杰, 杨博, 等. 股骨颈动力交叉钉系统内固定治疗股骨颈骨折术后早期股骨头坏死的危险因素分析[J]. 中国修复重建外科杂志, 2023, 37(2): 162-167.
|
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郭其发,杨成亮,王艺丹,沈通桃. 无阿片药麻醉诱导对气管插管患者血流动力学的影响. 实用临床医药杂志. 2022(22): 56-59 .
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申素峰,李景义,胡强夫. 右美托咪定与丙泊酚复合麻醉对脑膜瘤手术患者的麻醉效果及对血流动力学及脑组织的保护作用. 实用癌症杂志. 2022(12): 1971-1974 .
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