Reduction of valgus-impacted femoral neck fractures by bone hook pulling technique
10.3760/cma.j.cn115530-20240506-00196
- VernacularTitle:骨钩拉扽技术在外展嵌插型股骨颈骨折闭合复位中的应用
- Author:
Taotao REN
1
;
Bo WU
;
Yu CUI
;
Chengcheng ZHANG
;
Zhimeng WANG
;
Hongfei QI
;
Xianjie AI
;
Kun ZHANG
;
Zhong LI
;
Ming LI
Author Information
1. 延安大学医学院，延安 716000
- Publication Type:Journal Article
- Keywords:
Femoral neck fractures;
Fracture fixation, internal;
Bone nails;
Bone hook;
Femoral neck system;
Reduction of fracture;
Valgus-impacted
- From:
Chinese Journal of Orthopaedic Trauma
2024;26(12):1084-1088
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the bone hook pulling technique in reduction of valgus-impacted femoral neck fractures.Methods:A retrospective study was conducted to analyze the clinical data of 12 patients who had been treated from September 2021 to September 2022 for valgus-impacted femoral neck fractures at Department of Orthopaedics and Traumatology, Honghui Hospital. There were 6 males and 6 females with an age of (43.8±10.1) years. By the Garden classification, the 12 cases were all type Ⅰ; by the Pauwels classification, 10 cases were type Ⅰ and 2 cases type Ⅱ. All patients were definitively diagnosed preoperatively by radiographs and CT images. The bone hook pulling technique was used to extend the bone hook from the lateral side to the medial side of the lesser trochanter, pull the bone hook to the lateral side, and reset the fracture with the help of pulling force and the action of the surrounding soft tissue hinge. The fractures were then fixed with the Femoral Neck System (FNS). Length of surgical incision, number of fluoroscopy for bone hook-related operations, operation time, quality of fracture reduction, fracture healing time, functional recovery of the hip and shortening of the femoral neck at the last follow-up were recorded.Results:The 12 valgus-impacted femoral neck fractures were successfully reset by the hook pulling technique. In this cohort, the length of surgical incision was (4.6±0.7) cm, the number of fluoroscopy for bone hook-related operations (4.3±0.7) times, and the operation time (54.3±4.2) min. The 12 patients were followed up for (11.5±4.2) months postoperatively and the fracture healing time (4.2±0.7) months. According to the Garden score, the quality of postoperative fracture reduction was assessed as grade Ⅰ in 10 cases and as grade Ⅱ in 2 cases. According to the Harris hip score, the hip function was assessed as excellent in 10 cases and as good in 2 cases at the last follow-up. The length of femoral neck shortening was (1.17±0.68) mm at the last follow-up in the 12 patients; no complications related to fracture reduction were observed.Conclusion:In the reduction of valgus-impacted femoral neck fractures, bone hook pulling technique shows advantages of operational simplicity, a high rate of successful reduction, and satisfactory clinical effects.
