2023, Vol. 27 ›› Issue (9): 1390-1395

Femoral neck system combined with platelet-rich plasma in the treatment of femoral neck fracture

Zheng Hongrui, Zhang Wenjie, Wang Yunhua, He Bin, Shen Yajun, Fan Lei   

Abstract: BACKGROUND: For young patients with femoral neck fracture, the primary purpose of treatment is to achieve anatomical reduction and fixation to promote fracture healing. However, current studies have shown that after the occurrence of femoral neck fracture, the incidence of nonunion was 10%-30%; the incidence of femoral head necrosis was 15%-30%. Therefore, the risk to these patients is substantial.  
OBJECTIVE: To study the clinical efficacy of platelet-rich plasma combined with femoral neck system in the treatment of femoral neck fracture in young patients.
METHODS:   The clinical data of 52 patients (aged 18-55 years) with femoral neck fracture treated in Second Affiliated Hospital of Nanjing Medical University from January 2020 to January 2021 were included. Among them, 18 patients were treated with closed reduction and internal fixation with three cannulated screws (group A); 18 patients were treated with closed reduction and femoral neck system internal fixation (group B); 16 patients were treated with closed reduction and femoral neck system internal fixation combined with platelet-rich plasma (group C). The quality of fracture reduction was evaluated by anterior and lateral X-ray of femoral neck. Fracture healing at 6 months and 1 year after operation was evaluated by Fernandez-Esteve callus score. Hip joint function at 6 months and 1 year after operation was evaluated by Harris hip score. The incidence of femoral neck shortening was compared and analyzed between the two groups.  
RESULTS AND CONCLUSION: (1) All the 52 cases completed the operation successfully and no complications such as infection, re-fracture, or deep venous thrombosis of lower extremities occurred. They were followed up for at least one year. (2) The postoperative fracture healing in group C was better than that in groups A and B (P < 0.05). Harris hip score in group C was higher than that in groups A and B at 6 months and 1 year after operation (P < 0.05). At 6 months after operation, the Fernandez-Esteve callus score in group C was higher than that in groups A and B (P < 0.05). The incidence of femoral neck shortening in group C was lower than that in group A after operation (P < 0.05). (3) The surgical treatment of femoral neck fracture with femoral neck system combined with platelet-rich plasma is helpful to improve the therapeutic effect, promote fracture healing, reduce the occurrence of femoral neck shortening and improve the prognosis of patients.
Key words: femoral neck fracture, young patient, platelet-rich plasma, femoral neck system, fracture healing, femoral neck shortening, hip joint function