股骨颈骨折三枚空心拉力螺钉和股骨近端锁定钢板内固定治疗比较  

Therapeutic effect compared between three cannulated screws and proximal femoral locking plate in treatment of femoral neck fracture

作　　者：张楠[1] 丁亮华[1] 张晨然[1] 何双华[1] 张爱梁[1] 马文明[1] 

机构地区：[1]苏州大学第三附属医院骨三科,江苏常州213003

出　　处：《中国医师进修杂志》2013年第35期20-22,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的比较3枚空心拉力螺钉和股骨近端锁定钢板内固定治疗股骨颈骨折的疗效。方法75例股骨颈骨折患者分别接受3枚空心拉力螺钉治疗（3枚钉治疗组，31例）和股骨近端锁定钢板治疗（股骨近端锁定钢板治疗组，44例）。比较两组临床骨折愈合时间、末次随访时髋关节功能评分及术后并发症发生率。结果术后随访13～18（15．3±3．2）个月，股骨近端锁定钢板治疗组优良率为95．5％（42／44），3枚钉治疗组优良率为83．9％（26／31），两组比较差异无统计学意义（P〉0．05）。股骨近端锁定钢板治疗组临床骨折愈合时间及末次随访时髋关节功能评分优于3枚钉治疗组[（14．6±1．7）周比（18．1±4．9）周、（90．9±3．5）分比（82．3±8．3）分]，差异有统计学意义（P〈0．05）。结论股骨近端锁定钢板内固定治疗股骨颈骨折具有临床骨折愈合时间短、固定强度高、生物力学特性好、术后并发症发生率低等优点，值得临床推广应用。Objective To compare the therapeutic effect between three cannulated screws and proximal femora[ locking plate in treatment of femoral neck fracture. Methods A total of 75 patients were included, the three cannulated screws group contained 31 patients, and the proximal femoral locking plate group contained 44 patients. The clinical healing time, hip function score at last follow-up and postoperative complication were compared. Results All patients were followed up for 13 - 18 （ 15.3 ± 3.2） months. The excellent and good rate of proximal femoral locking plate group was 95.5%（42±44）,and three cannulated screws group was 83.9% （ 26/31 ）, there was no statistical difference between the two groups （P 〉 0.05 ）. The clinical healing time of fracture and hip function score at last follow-up in proximal femoral locking plate group were significantly better than those in three cannulated screws group [ （14.6 ± 1.7 ） weeks vs. （18.1 ± 4.9 ） weeks, （90.9 ± 3.5 ） scores vs. （ 82.3 ± 8.3 ） scores ], there were statistical differences between the two groups （P 〈 0.05）. Conclusions Proximal femoral locking plate provides short clinical healing time of fracture,stable fixation,good biomechanical properties and a low rate of postoperative complication in treatment of femoral neck fracture. It is one of the ideal methods in treatment of femoral neck fracture.

关 键 词：股骨颈骨折 锁定钢板 空心拉力螺钉 骨折内固定 

分 类 号：R687.3[医药卫生—骨科学]