Comparison of Transverse Cancellous Lag Screw and Ordinary Cannulated Screw Fixations in Treatment of Vertical Femoral Neck Fractures

Objective To compare the clinical therapeutic effect of transverse cancellous lag screw (TCLS) fixations and ordinary cannulated screw (OCS) fixations for vertical femoral neck fractures. Methods A total of 62 eligible patients with an average age of 56.2 years (range, 19–45 years; 40 male and 22 fe...

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Main Authors: Qiang Dong, Zhe Han, Yin‐Guang Zhang, Xiang Sun, Xin‐Long Ma
Format: Article
Language:English
Published: Wiley 2019-08-01
Series:Orthopaedic Surgery
Subjects:
Online Access:https://doi.org/10.1111/os.12503
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author Qiang Dong
Zhe Han
Yin‐Guang Zhang
Xiang Sun
Xin‐Long Ma
author_facet Qiang Dong
Zhe Han
Yin‐Guang Zhang
Xiang Sun
Xin‐Long Ma
author_sort Qiang Dong
collection DOAJ
description Objective To compare the clinical therapeutic effect of transverse cancellous lag screw (TCLS) fixations and ordinary cannulated screw (OCS) fixations for vertical femoral neck fractures. Methods A total of 62 eligible patients with an average age of 56.2 years (range, 19–45 years; 40 male and 22 female) with Pauwels’ type III femoral neck fractures were recruited in our study from January 2016 to December 2017. Among the patients, 30 underwent TCLS fixation (TCLS group), and the others were treated with OCS fixation (OCS group). The baseline data, perioperative outcomes (operative time, intra‐operative blood loss, reduction quality, and hospital time), postoperative outcomes evaluated by a variety of scales including visual analogue scale (VAS) score, EuroQol five dimensions questionnaire (EQ‐5D) and Harris hip scores (HHS), and complications (nonunion, femoral head necrosis, femoral neck shortening, and failure of fixation) of the two groups were recorded to compare at 12‐month follow‐up. Results The mean follow‐up time of included patients was 13.4 ± 1.6 months in the TCLS group and 13.7 ± 0.9 months in the OCS group. There was no statistically significant difference in the baseline data as well as perioperative outcomes, including operative time, intra‐operative blood loss, the hemoglobin difference before and after treatment, quality of reduction, and hospital time between two groups. Likewise, the VAS score, the EQ‐5D score, and complications rates including nonunion and femoral head necrosis had no distinct difference in two groups. However, HHS in the TCLS group were superior to those in the OCS group at 12‐month follow‐up, and the femoral neck shortening rate was prominently reduced in the TCLS group when compared with the OCS group. Conclusions Treating vertical femoral neck fractures with the TCLS technique could significantly improve hip functional recovery and reduce the postoperative femoral neck shortening rate. The present study provides novel insight for the treatment of vertical femoral neck fractures.
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spelling doaj.art-5d3ed62471cd463cb01abc94460956f12022-12-21T18:40:00ZengWileyOrthopaedic Surgery1757-78531757-78612019-08-0111459560310.1111/os.12503Comparison of Transverse Cancellous Lag Screw and Ordinary Cannulated Screw Fixations in Treatment of Vertical Femoral Neck FracturesQiang Dong0Zhe Han1Yin‐Guang Zhang2Xiang Sun3Xin‐Long Ma4Department of Traumatology Tianjin Hospital Tianjin ChinaDepartment of Traumatology Tianjin Hospital Tianjin ChinaDepartment of Traumatology Tianjin Hospital Tianjin ChinaDepartment of Traumatology Tianjin Hospital Tianjin ChinaDepartment of Orthopaedics Tianjin Hospital Tianjin ChinaObjective To compare the clinical therapeutic effect of transverse cancellous lag screw (TCLS) fixations and ordinary cannulated screw (OCS) fixations for vertical femoral neck fractures. Methods A total of 62 eligible patients with an average age of 56.2 years (range, 19–45 years; 40 male and 22 female) with Pauwels’ type III femoral neck fractures were recruited in our study from January 2016 to December 2017. Among the patients, 30 underwent TCLS fixation (TCLS group), and the others were treated with OCS fixation (OCS group). The baseline data, perioperative outcomes (operative time, intra‐operative blood loss, reduction quality, and hospital time), postoperative outcomes evaluated by a variety of scales including visual analogue scale (VAS) score, EuroQol five dimensions questionnaire (EQ‐5D) and Harris hip scores (HHS), and complications (nonunion, femoral head necrosis, femoral neck shortening, and failure of fixation) of the two groups were recorded to compare at 12‐month follow‐up. Results The mean follow‐up time of included patients was 13.4 ± 1.6 months in the TCLS group and 13.7 ± 0.9 months in the OCS group. There was no statistically significant difference in the baseline data as well as perioperative outcomes, including operative time, intra‐operative blood loss, the hemoglobin difference before and after treatment, quality of reduction, and hospital time between two groups. Likewise, the VAS score, the EQ‐5D score, and complications rates including nonunion and femoral head necrosis had no distinct difference in two groups. However, HHS in the TCLS group were superior to those in the OCS group at 12‐month follow‐up, and the femoral neck shortening rate was prominently reduced in the TCLS group when compared with the OCS group. Conclusions Treating vertical femoral neck fractures with the TCLS technique could significantly improve hip functional recovery and reduce the postoperative femoral neck shortening rate. The present study provides novel insight for the treatment of vertical femoral neck fractures.https://doi.org/10.1111/os.12503Femoral head necrosisFemoral neck shorteningNonunionTransverse cancellous lag screwVertical femoral neck fractures
spellingShingle Qiang Dong
Zhe Han
Yin‐Guang Zhang
Xiang Sun
Xin‐Long Ma
Comparison of Transverse Cancellous Lag Screw and Ordinary Cannulated Screw Fixations in Treatment of Vertical Femoral Neck Fractures
Orthopaedic Surgery
Femoral head necrosis
Femoral neck shortening
Nonunion
Transverse cancellous lag screw
Vertical femoral neck fractures
title Comparison of Transverse Cancellous Lag Screw and Ordinary Cannulated Screw Fixations in Treatment of Vertical Femoral Neck Fractures
title_full Comparison of Transverse Cancellous Lag Screw and Ordinary Cannulated Screw Fixations in Treatment of Vertical Femoral Neck Fractures
title_fullStr Comparison of Transverse Cancellous Lag Screw and Ordinary Cannulated Screw Fixations in Treatment of Vertical Femoral Neck Fractures
title_full_unstemmed Comparison of Transverse Cancellous Lag Screw and Ordinary Cannulated Screw Fixations in Treatment of Vertical Femoral Neck Fractures
title_short Comparison of Transverse Cancellous Lag Screw and Ordinary Cannulated Screw Fixations in Treatment of Vertical Femoral Neck Fractures
title_sort comparison of transverse cancellous lag screw and ordinary cannulated screw fixations in treatment of vertical femoral neck fractures
topic Femoral head necrosis
Femoral neck shortening
Nonunion
Transverse cancellous lag screw
Vertical femoral neck fractures
url https://doi.org/10.1111/os.12503
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