摘要
目的比较空心钉辅助加压股骨近端空心钉锁定板与单纯空心加压螺钉治疗青壮年股骨颈骨折近期疗效。方法回顾性分析2013年1月至2015年1月收治的56例股骨颈骨折患者的临床资料。根据不同内固定方式分为两组,空心钉辅助加压股骨近端空心钉锁定板组(A组)30例,男18例,女12例;单纯空心加压螺钉组(B组)26例,男15例,女11例。比较两组患者的手术时间、术中出血量、骨折愈合时间、骨折不愈合发生率、股骨头缺血性坏死率、内固定失败率、髋关节功能评分(Harris评分)并进行统计学分析。结果56例患者术后均获得随访,时间18~30个月,平均24个月。两组患者在骨折不愈合率、股骨头缺血性坏死率方面差异无统计学意义(P>0.05)。手术时间A组为(94.70±4.96)min,B组为(67.30±5.65)min,差异有统计学意义(P<0.05);术中出血量A组为(144.27±26.42)mL,B组为(77.73±7.86)mL,差异具有统计学意义(P<0.05);骨折愈合时间A组(11.33±1.09)个月,B组(13.19±1.27)个月,差异具有统计学意义(P<0.05)。术后A组未出现内固定失败病例,B组出现5例螺钉松动、退钉及切割股骨头病例,差异有统计学意义(P<0.05)。术后18个月Harris评分A组(80.87±2.55)分,优于B组(79.30±2.96)分,差异具有统计学意义(P<0.05)。结论与传统空心钉相比,空心钉辅助加压股骨近端空心钉锁定板治疗股骨颈骨折固定及加压效果可靠,骨折愈合时间缩短,内固定物失败率更少,患髋功能评分更高,但手术操作更复杂,导致手术时间延长及出血量增加。
Objective To compare the short term clinical effects of proximal femoral cannulated screw locking plate compressed by cannulated compression screw and cannulated screws in treating young adults with femoral neck frac tures.Methods The clinical data of 56 cases with femoral neck fracture treated in our hospital from January 2013 to January 2015 were analyzed retrospectively.The patients were divided into two groups(group A and B)based on the dif-ferent fixation method.Of them,30 cases(group A,18 males and 12 females)were treated with proximal femoral cannu-lated screw locking plate compressed by cannulated compression screw and 26 cases(group B,15 males and 11 females)with three compressed canulated screws.Operative time,intraoperative blood loss,healing time of fracture,incidence of non union and femoral head necrosis,incidence of failure fixation,joint function(Harris score)were compared between two groups,and statistical analysis was performed.Results All 56 patients were followed up from 18 to 30 months with an average of 24 months.There was no significant differences in incidence of non union and femoral head necrosis between two groups(P〉0.05).Operative time of group A(94.70±4.96)min was more than that of group B(67.30±5.65)min(P〈0.05).Intraoperative blood loss of group A(144.27±26.42)mL was more than that of group B(77.73±7.86)mL(P〈0.05).Healing time of fracture of group A(11.33±1.09)months was less than that of group B(13.19±1.27)months(P〈0.05).In group A,there were no internal fixation failure cases;and in group B,screw retreating oc-curred in 3 cases,screw cutout from the femoral head occurred in 2 cases;there was significant differences between the two groups(P〈0.05).Joint function(Harris score)of group A(80.87±2.55)was higher than that of group B(79.30±2.96)(P〈0.05).Conclusion Proximal femoral cannulated screw locking plate compressed by cannulated compres-sion screw has advantages of reliable fixation in treatment of femoral neck fractures.Compared with the traditional three compressed canulated screws,proximal femoral cannulated screw locking plate compressed by cannulated compression screw has less healing time and fixation failure rate and higher hip function scoring.But this operation mode is more complicated,the operation time is prolonged and the amount of Intraoperative blood loss is increased.
作者
王桂华
冯玉旭
谭力
王梅生
陈福扬
Wang Guihua;Feng Yuxu;Tan Li(Department of Orthopedics,Pukou Central Hospital,Nanjing211800,China)
出处
《实用骨科杂志》
2017年第12期1073-1077,共5页
Journal of Practical Orthopaedics
关键词
股骨颈骨折
股骨近端
空心钉锁定钢板
空心加压螺钉
内固定术
femoral neck fracture
proximal femoral
cannulated screw
cannulated compression screws
internal fixation
