实用医学杂志 ›› 2022, Vol. 38 ›› Issue (23): 2962-2967.doi: 10.3969/j.issn.1006⁃5725.2022.23.013

• 临床研究 • 上一篇    下一篇

股骨颈动力交叉钉系统和空心钉治疗Pauwels Ⅲ股骨颈骨折近期疗效 

翁友林 李祖涛 蔡昱 孙俊刚 徐江波    

  1. 新疆维吾尔自治区人民医院骨科创伤病区(乌鲁木齐 830000)

  • 出版日期:2022-12-10 发布日期:2022-12-10
  • 通讯作者: 徐江波 E⁃mail:xjb58sh@163.com
  • 基金资助:
    新疆维吾尔自治区自然科学基金(编号:2019D01C106)

The short ⁃ term efficacy of femoral neck system versus that of cannulated compression screw for Pauwels type Ⅲ femoral neck fracture

WENG Youlin,LI Zutao,CAI Yu,SUN Jungang,XU Jiangbo.   

  1. People′s Hospi⁃ tal of Xinjiang Uygur Autonomous Region Orthopedic Trauma Ward,Urumqi 830000,China

  • Online:2022-12-10 Published:2022-12-10
  • Contact: XU Jiangbo E⁃mail:xjb58sh@163.com

摘要:

目的 探讨股骨颈动力交叉钉系统(FNS)和空心钉(CCS)治疗 Pauwels Ⅲ型股骨颈骨折 的临床疗效。方法 回顾性分析 2020 年 1 月至 2021 年 6 月新疆维吾尔自治区人民医院骨科收治的 52 例 Pauwels Ⅲ型股骨颈骨折患者的临床资料,根据内固定方式不同分为两组:FNS组(= 26)和CCS组(= 26)。 比较两组患者的手术时间、术中出血量、切口大小、X 线透视次数、骨折愈合时间,Garden 对线指数评定骨 折复位质量,术后 1 年股骨颈短缩程度、颈干角丢失程度、股骨头坏死率和骨折不愈合率,术后 1 年采用 Harris 评分评价髋关节功能恢复程度。结果 FNS 组术中透视次数、骨折愈合时间、术后 1 年股骨颈短缩 程度、颈干角丢失程度、髋关节Harris评分优于CCS组(< 0.05);CCS组术中出血量小于FNS组(< 0.05); 术后 Garden 对线指数、术后 1 年股骨头坏死率、骨折不愈合率两组间比较差异无统计学意义(> 0.05)。 结论 FNS 治疗Pauwels Ⅲ型股骨颈骨折临床近期疗效肯定,术中透视次数,术后股骨颈短缩程度、颈干角 丢失程度、髋关节Harris 评分优于CCS 组,可作为Pauwels Ⅲ型股骨颈骨折的优选方案。 

关键词:

股骨颈骨折,  , 骨折内固定术,  , 空心钉,  , 股骨颈动力交叉钉系统

Abstract:

Objective To explore the clinical efficacy of femoral neck system(FNS)and cannulated compression screw(CCS)in the treatment of Pauwels type Ⅲ femoral neck fracture. Methods The clinical data on 52 patients with Pauwels type Ⅲ femoral neck fracture admitted to the Department of Orthopedics and Trauma of the People′s Hospital of Xinjiang Uygur Autonomous Region from January 2020 to June 2021 were retrospectively analyzed. According to different internal fixation modes,they were divided into two groups:FNS group(26 patients), CCS group(26 patients). The surgical duration,intraoperative blood loss,incision size,figure of X⁃ray fluorosco⁃ py,and time to fracture healing were compared between the two groups. The quality of fracture reduction was assessed by Garden alignment index. The degrees of femoral neck shortening and neck angle loss and rates of femoral head necrosis and fracture nonunion were followed up one year after the procedures. Harris score was used to evaluate the degree of hip function recovery one year after operation. Results There was no significant difference in preoperative general data between the two groups(P > 0.05),which was comparable. The intraoperative figure of fluoroscopy,time to fracture healing,degree of femoral neck shortening,degree of neck angle loss,and Harris score on hip joint one year after surgery were significantly better in FNS group than in CCS group,and intraopera⁃ tive blood loss in CCS group was less than that in FNS group(P < 0.05). There were no significant differences in postoperative Garden alignment index and rates of femoral head necrosis and fracture nonunion between the two groups(P > 0.05). Conclusions FNS has a positive short ⁃term clinical efficacy in the treatment of Pauwels Ⅲ type femoral neck fracture. The figure of intraoperative fluoroscopy,degrees of postoperative femoral neck shortening and neck shaft angle loss,and Harris score on hip joint are better than those in the CCS group,which can be used as a preferred scheme for Pauwels type Ⅲ femoral neck fracture.

Key words:

femoral neck fracture, internal fracture fixation, cannulated compression screw, femo? ral neck system