Measurement of femoral neck shortening after cannulated screwing for elderly femoral neck fractures and the effect of shortening on hip function
10.3760/cma.j.issn.1671-7600.2014.08.002
- VernacularTitle:老年股骨颈骨折空心螺钉固定术后颈短缩的测量及其对髋关节功能的影响
- Author:
Xi XIA
;
Zhi LIU
- Publication Type:Journal Article
- Keywords:
Femoral neck fractures;
Fracture fixation,internal;
Bone nails;
Aged;
Shortening
- From:
Chinese Journal of Orthopaedic Trauma
2014;16(8):651-655
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the measurement of femoral neck shortening (FNS) after cannulated screwing for elderly femoral neck fractures and the effect of FNS on hip functional outcome.Methods Totally 214 elderly patients with femoral neck fracture were included in this study who had been treated by fixation with cannulated screws from June 2007 to October 2013.They were 71 males and 143 females,with an average age of 77.2 years.According to Garden classification system,65 cases were types Ⅰ and Ⅱ (undisplaced fractures),and 149 types Ⅲ and Ⅳ (displaced fractures).The postoperative X-ray and follow-up X-ray films were compared to observe whether the trailing end of screw shaft was exposed to the outer cortex of the proximal femur.We chose the screw which had the longest exposure of trailing end to measure the length of the exposed screw shaft as the length of FNS.FNS indexes were defined according to the ratio of the length of exposed screw shaft to the thickness of screw head.FNS degree 1:＜ 1 screw head; FNS degree 2:1 to 2 screw heads; FNS degree 3:＞ 2 screw heads.The relationships of the FNS length respectively with thefemur length decrease and Harris scores of hip functional outcome were analyzed statistically.Results FNS occurred in 78 cases,giving an incidence of FNS of 36.4％ (78/214).Of them,12 cases (15.4％)were defined as degree 1,24 cases (30.8％) as degree 2,and 42 cases (53.8％) as degree 3.There was a significant positive correlation between the FNS length and the femur length decrease(r =0.919,P =0.000).The average Harris score at 12 months postoperation for 180 cases was 77.3 points (ranging from 32 to 98 points).The average Harris score for those with FNS was significantly lower than that for those without FNS (t =9.904,P =0.000).There was a significant negative correlation between the FNS length and Harris scores (r =-0.707,P =0.000).Conclusions Our measurement of FNS and FNS indexes are easy to be used in clinic.Severe FNS can influence the function of hip joint.
