Quadratus femoris muscle pedicle bone flap transplantation combined with hollow compression screw fixation versus AO hollow compression screw fixation in the repair of femoral neck fracture in young and middle-aged patients

doi:10.3969/j.issn.2095-4344.2014.48.015

Abstract

Abstract:

BACKGROUND: There is no unified treatment standard for femoral neck fracture in the clinic. Quadratus femoris muscle pedicle bone flap transplantation combined with hollow compression screw fixation and AO hollow compression screw fixation are common methods for treatment of femoral neck fracture, but both of them have their advantages and disadvantages.
OBJECTIVE: To investigate the effects and complication rates of quadratus femoris muscle pedicle bone flap transplantation combined with hollow compression screw fixation and AO hollow compression screw fixation in young and middle-aged patients with Garden III and IV types of femoral neck fracture.
METHODS: A total of 60 young and middle-aged patients with femoral neck fracture were divided into observation group and control group according to the different treatment methods. The observation group was treated with quadratus femoris muscle pedicle bone flap transplantation combined with hollow compression screw fixation. The control group was treated with AO hollow compression screw fixation. Fracture healing time, healing rate, excellent and good rate, the rate of avascular necrosis and late collapse rate were compared between the two groups.
RESULTS AND CONCLUSION: (1) The fracture healing time of the observation group was less than that of the control group. The healing rate and the excellent and good rate were significantly higher in the observation group than those in the control group (P < 0.05). (2) Fracture healing time in patients of the observation group was less than that of the control group, but the healing rate and the excellent and good rate of fracture was significantly higher than those in the control group (P < 0.05). These data suggested that the quadratus femoris muscle pedicle bone flap transplantation combined with hollow compression screw fixation have good effects in the treatment of Garden III and IV types of femoral neck fracture in the young and middle-aged patients.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: femoral fractures, internal fixators, bone nails, femur head

CLC Number:

R318

Zha Qing-lin, Zhang Hong-cheng, Lu Cheng-yun, Zhu Yu-ke. Quadratus femoris muscle pedicle bone flap transplantation combined with hollow compression screw fixation versus AO hollow compression screw fixation in the repair of femoral neck fracture in young and middle-aged patients [J]. Chinese Journal of Tissue Engineering Research, 2014, 18(48): 7792-7796.

Figures/Tables 3

References

[1] 李波,邹正,罗文中.不同股骨颈骨折分型与中青年股骨颈骨折预后的相关性研究[J].重庆医学,2013,42(3):297-298,301.
[2] Vaishya R, Shrestha SK, Vaish A. A Galeazzi-variant type fracture-dislocation in adults. Chin J Traumatol. 2013;16(6): 344-346.
[3] Maeda H, Yoshida K, Doi R, et al. Combined Monteggia and Galeazzi fractures in a child: a case report and review of the literature. J Orthop Trauma. 2003;17(2): 128-131.
[4] Stoffelen D, Fortems Y, De Smet L, et al. Dislocation of the distal radioulnar joint associated with a transstyloid radiocarpal fracture dislocation. A case report and review of the literature. Acta Orthop Belg. 1996;62(1):52-55.
[5] Lee K. Global trends in maxillofacial fractures. Craniomaxillofac Trauma Reconstr. 2012;5(4):213-222.
[6] Perron AD, Hersh RE, Brady WJ, et al. Orthopedic pitfalls in the ED: Galeazzi and Monteggia fracture-dislocation. Am J Emerg Med. 2001;19(3):225-228.
[7] Lee K. Global trends in maxillofacial fractures. Craniomaxillofac Trauma Reconstr. 2012;5(4):213-222.
[8] Carlsen BT, Dennison DG, Moran SL. Acute dislocations of the distal radioulnar joint and distal ulna fractures. Hand Clin. 2010;26(4):503-516.
[9] Lee KH, Snape L, Steenberg LJ, et al. Comparison between interpersonal violence and motor vehicle accidents in the aetiology of maxillofacial fractures. ANZ J Surg. 2007;77(8): 695-698.
[10] Yoffe T, Shohat I, Shoshani Y, et al. Etiology of maxillofacial trauma--a 10-year survey at the Chaim Sheba Medical Center, Tel-Hashomer. Harefuah. 2008;147(3):192-196, 280.
[11] Mijiti A, Ling W, Tuerdi M, et al. Epidemiological analysis of maxillofacial fractures treated at a university hospital, Xinjiang, China: A 5-year retrospective study. J Craniomaxillofac Surg. 2014;42(3):227-233.
[12] Gandhi S, Ranganathan LK, Solanki M, et al. Pattern of maxillofacial fractures at a tertiary hospital in northern India: a 4-year retrospective study of 718 patients. Dent Traumatol. 2011;27(4):257-262.
[13] Rahman RA, Ramli R, Rahman NA, et al. Maxillofacial trauma of pediatric patients in Malaysia: a retrospective study from 1999 to 2001 in three hospitals. Int J Pediatr Otorhinolaryngol. 2007;71(6):929-936.
[14] van den Bergh B, Karagozoglu KH, Heymans MW, et al. Aetiology and incidence of maxillofacial trauma in Amsterdam: a retrospective analysis of 579 patients. J Craniomaxillofac Surg. 2012;40(6):e165-169.
[15] Ozgursoy OB, Muderris T, Yorulmaz I, et al. Demographic, epidemiologic, and surgical characteristics of maxillofacial fracture repair in a developing country. Ear Nose Throat J. 2009;88(4):E20-24.
[16] Martini MZ, Takahashi A, de Oliveira Neto HG, et al. Epidemiology of mandibular fractures treated in a Brazilian level I trauma public hospital in the city of São Paulo, Brazil. Braz Dent J. 2006;17(3):243-248.
[17] 张德宝,王铁军,谷贵山.高龄股骨颈骨折患者行全髋关节置换与人工双极股骨头置换的比较[J].中国组织工程研究与临床康复, 2008,12(9):1651-1654.
[18] 刘志雄.常用骨科分类法和功能评定[M]. 北京:科学技术出版社, 2010:221-230.
[19] 陈跃平,高辉,陈亮,等.关节置换与植入物内固定治疗老年移位型股骨颈骨折的系统评价[J].中国组织工程研究,2012,16(9): 1656-1660.
[20] 魏杰,张登君,郭秀生,等.股方肌骨瓣移位空心钉内固定治疗青壮年股骨颈骨折的中长期疗效[J].中华显微外科杂志,2012, 35(5): 370-373.
[21] 谢延华,王凤龙,林潮炫,等.空心钉内固定与联合股方肌骨瓣治疗青壮年股骨颈骨折的疗效比较[J].广东医学院学报,2013,31(5): 571-573.
[22] 韵向东,夏亚一,万麟,等.股方肌骨瓣移植术治疗青壮年股骨颈骨折中远期随访[J].中国骨伤,2010,23(3)164-166.
[23] Zahid M, Bin Sabir A, Asif N, et al. Fixation using cannulated screws and fibular strut grafts for fresh femoral neck fractures with posterior comminution. J Orthop Surg (Hong Kong). 2012; 20(2):191-195.
[24] Raaymakers EL. Fractures of the femoral neck: a review and personal statement. Acta Chir Orthop Traumatol Cech. 2006; 73(1):45-59.
[25] Sen RK, Tripathy SK, Goyal T, et al. Osteosynthesis of femoral-neck nonunion with angle blade plate and autogenous fibular graft. Int Orthop. 2012;36(4):827-832.
[26] Chen Z, Wang G, Lin J, et al. Efficacy comparison between dynamic hip screw combined with anti-rotation screw and cannulated screw in treating femoral neck fractures. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011;25(1): 26-29.
[27] Sahin S, Ertürer E, Oztürk I, et al. Radiographic and functional results of osteosynthesis using the proximal femoral nail antirotation (PFNA) in the treatment of unstable intertrochanteric femoral fractures. Acta Orthop Traumatol Turc. 2010;44(2):127-134.
[28] Dewei Z, Xiaobing Y. A retrospective analysis of the use of cannulated compression screws and a vascularised iliac bone graft in the treatment of displaced fracture of the femoral neck in patients aged < 50 years. Bone Joint J. 2014;96-B(8): 1024-1028.
[29] Rawall S, Bali K, Upendra B, et al. Displaced femoral neck fractures in the young: significance of posterior comminution and raised intracapsular pressure. Arch Orthop Trauma Surg. 2012;132(1):73-79.
[30] Tian W, Cui Z, Kan S. Comparison of cannulated screws fixation with different reduction methods at different time points for displaced femoral neck fractures in terms of fracture healing. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2009; 23(4):440-443.
[31] LeCroy CM, Rizzo M, Gunneson EE, et al. Free vascularized fibular bone grafting in the management of femoral neck nonunion in patients younger than fifty years. J Orthop Trauma. 2002;16(7):464-472.
[32] Asnis SE, Wanek-Sgaglione L. Intracapsular fractures of the femoral neck. Results of cannulated screw fixation. J Bone Joint Surg Am. 1994;76(12):1793-1803.
[33] Rodríguez-Merchán EC. In situ fixation of nondisplaced intracapsular fractures of the proximal femur. Clin Orthop Relat Res. 2002;(399):42-51.
[34] Cho MR, Lee SW, Shin DK, et al. A predictive method for subsequent avascular necrosis of the femoral head (AVNFH) by observation of bleeding from the cannulated screw used for fixation of intracapsular femoral neck fractures. J Orthop Trauma. 2007;21(3): 158-164.
[35] Haidukewych GJ, Rothwell WS, Jacofsky DJ, et al. Operative treatment of femoral neck fractures in patients between the ages of fifteen and fifty years. J Bone Joint Surg Am. 2004; 86-A(8):1711-1716.
[36] Nikolopoulos KE, Papadakis SA, Kateros KT, et al. Long-term outcome of patients with avascular necrosis, after internal fixation of femoral neck fractures. Injury. 2003;34(7):525-528.
[37] Mao YJ, Wei J, Zhou L, et al. Related factor analysis of avascular necrosis of the femoral head after internal fixation with cannulated screws in femoral neck fractures. Zhonghua Yi Xue Za Zhi. 2005;85(46):3256-3259.
[38] Lin SQ, Peng LP, Yao ZC. Case-control study on cannulated screw fixation and percutaneous autogenous bone marrow grafting for the treatment of femoral neck fractures. Zhongguo Gu Shang. 2010;23(9):675-678.
[39] Staeheli JW, Frassica FJ, Sim FH. Prosthetic replacement of the femoral head for fracture of the femoral neck in patients who have Parkinson disease. J Bone Joint Surg Am. 1988; 70(4):565-568.
[40] Nowotarski PJ, Turen CH, Brumback RJ, et al. Conversion of external fixation to intramedullary nailing for fractures of the shaft of the femur in multiply injured patients. J Bone Joint Surg Am. 2000;82(6):781-788.
[41] Tidermark J, Zethraeus N, Svensson O, et al. Quality of life related to fracture displacement among elderly patients with femoral neck fractures treated with internal fixation. J Orthop Trauma. 2002;16(1):34-38.
[42] Pelet S, Leyvraz PF, Garofalo R, et al. Sub- or intertrochanteric fracture following screw fixation of an intracapsular proximal femoral fracture: true complication or technical error? Swiss Surg. 2003;9(2):82-86.
[43] Staeheli JW, Frassica FJ, Sim FH. Prosthetic replacement of the femoral head for fracture of the femoral neck in patients who have Parkinson disease. J Bone Joint Surg Am. 1988; 70(4):565-568.
[44] 王满宜,危杰.股骨颈骨折临床研究的若干问题与新概念[J].中华创伤骨科杂志,2003,5(1):5.