Femoral neck fractures account for 50% of hip fractures. For non-elderly patients with femoral neck fractures, internal fixation treatment is usually recommended. However, postoperative complications, such as nonunion of the fracture, femoral head necrosis, and femoral neck shortening, are quite common in clinical practice. Currently, most research focuses on how to prevent femoral head necrosis after internal fixation of femoral neck fractures, while less attention is given to the issue of femoral neck shortening.
Currently, internal fixation methods for femoral neck fractures, including the use of three cannulated screws, FNS (Femoral Neck System), and dynamic hip screws, all aim to prevent femoral neck varus and provide axial compression to avoid nonunion. However, uncontrolled or excessive sliding compression inevitably leads to femoral neck shortening. In light of this, experts from the Second People's Hospital Affiliated with Fujian University of Traditional Chinese Medicine, considering the importance of femoral neck length in fracture healing and hip function, proposed the use of an "anti-shortening screw" in combination with FNS for femoral neck fracture fixation. This approach has shown promising results, and the research was published in the latest issue of the journal Orthopaedic Surgery.
The article mentions two types of "anti-shortening screws": one being a standard cannulated screw and the other a screw with a dual-thread design. Out of the 53 cases in the anti-shortening screw group, only 4 cases used the dual-threaded screw. This raises the question of whether the partially threaded cannulated screw truly has an anti-shortening effect.
When both the partially threaded cannulated screws and dual-threaded screws were analyzed together and compared to traditional FNS internal fixation, the results showed that the degree of shortening in the anti-shortening screw group was significantly lower than in the traditional FNS group at the 1-month, 3-month, and 1-year follow-up points, with statistical significance. This raises the question: Is the effect due to the standard cannulated screw or the dual-threaded screw?
The article presents 5 cases involving anti-shortening screws, and upon closer examination, it can be seen that in cases 2 and 3, where partially threaded cannulated screws were used, there was noticeable screw retraction and shortening (the images labeled with the same number correspond to the same case).
Based on the case images, the effectiveness of the dual-threaded screw in preventing shortening is quite apparent. As for the cannulated screws, the article does not provide a separate comparison group for them. However, the article does offer a valuable perspective on femoral neck internal fixation, emphasizing the importance of maintaining femoral neck length.
Post time: Sep-06-2024
