2022, Vol. 26 ›› Issue (33): 5290-5296

Femoral neck fractures in middle-aged and young adults using femoral neck system assisted by 3D printed guide plate

Sheng Xiaolei1, Liu Su1, Wang Jin1, Zhao Lei1, Zhu Yi1, Zhang Wei1, Gu Qi1, Yuan Feng2, Tian Shoujin1, Ge Jianfei1   

Abstract: BACKGROUND: Internal fixation is often the first choice for patients in middle-aged and young adults. However, there are some risks in traditional internal fixation treatment, such as failure of internal fixation, nonunion of fracture and avascular necrosis of the femoral head. Therefore, it is of great clinical significance to choose a suitable internal fixation system for femoral neck fracture.  
OBJECTIVE: To explore the application value of 3D printed guide plate assisted new femoral neck system in the treatment of femoral neck fracture in middle-aged and young adults.
METHODS: Totally 24 patients of middle-aged and young adults with femoral neck fracture who underwent surgery with femoral neck system in the Department of Orthopedics, Zhangjiagang Hospital Affiliated to Soochow University from 2020 to 2021 were randomly divided into two groups (n=12 per group). The experimental group designed and made 3D printed guide plate to assist the femoral neck system internal fixation operation before operation, while the control group was treated with freehand new femoral neck system for internal fixation. The general data, operation and follow-up results (fracture healing time, visual analogue scale score and Harris score before operation, 1 week and 6 months after operation), and complications were compared between the two groups.  
RESULTS AND CONCLUSION: (1) All the 24 patients were followed up for more than 6 months. (2) The operation time, the times of fluoroscopy and the amount of intraoperative blood loss in the experimental group were significantly less than those in the control group (P < 0.05). (3) During the last follow-up, all patients in the experimental group and control group achieved bone healing. There were no complications such as internal fixation failure and avascular necrosis of the femoral head in the experimental group and control group. (4) The hip pain was significantly relieved in the two groups. The visual analogue scale score in the experimental group was lower than that in the control group at 1 week and 6 months after operation, and the difference was not statistically significant (P > 0.05). (5) The hip joint function of the two groups was significantly improved after operation. The Harris score of the experimental group was better than that of the control group at 1 week and 6 months after operation, and the difference was not statistically significant (P > 0.05). (6) The results show that the new femoral neck system has achieved a good surgical efficacy in the treatment of femoral neck fracture in middle-aged and young adults. Femoral neck system assisted by 3D printed guide plate can reduce the operation time and fluoroscopy times, and the amount of intraoperative blood loss.
Key words: femoral neck fracture, 3D printing, guide plate, new femoral neck system, follow-up