不同复位方式下空心钉内固定治疗移位股骨颈骨折的疗效观察  

The curative effect of different reset mode cannulated screw internal fixation the treatment of displaced femoral neck fracture

作　　者：蒋仕林[1] 倪诚[1] 杜亮[1] 李国庆[1] JIANG Shilin NI Cheng DU Liang LI Guoqing(Department of Orthopedics, Jiangong Hospital of Shanghai, Shanghai 200083, Chin)

机构地区：[1]上海建工医院骨科,上海200083

出　　处：《西部医学》2017年第2期257-260,264,共5页Medical Journal of West China

摘　　要：目的探讨切开复位与闭合复位空心钉内固定治疗移位股骨颈骨折的疗效。方法选择2012年1月~2015年5月我院收治的移位股骨颈骨折患者96例为研究对象,根据复位方式的不同分为切开复位组(45例)和闭合复位组(51例),两组患者复位后均采用3枚空心钉内固定,比较两组手术一般情况、临床疗效及并发症发生情况。结果与闭合复位组比较,切开复位组手术时间、术中出血量、骨折复位质量优良率、末次随访时髋关节功能Harris评分升高,股骨头坏死发生率降低(均P<0.05);两组术中透视时间,骨折不愈合发生、髋内翻发生率、内固定滑脱发生率比较,差异无统计学意义(P>0.05)。结论与闭合复位空心钉内固定比较,切开复位空心钉内固定治疗移位股骨颈骨折对患者机体创伤更大,但能获得更理想的骨折复位效果、降低股骨头坏死发生率,远期疗效更理想。Objective To explore the curative effect of incision reduction cannulated screw internal fixation with closed reduction and hollow screw fixation in the treatment of displaced femoral neck fractures. Methods 96 femoral neck fracture patients were divided into the incision reduction group （45 cases） and closed reduction group （51 cases）, according to the different methods of reduction. All the patients adopted three cannulated screw internal fixation after reset. The general surgery, clinical curative effect and complications were observed. Results The operation time, the intraoperative blood loss, the fracture rate of good quality, Harris hip score of the last follow-up function and the incidence of femoral head necrosis of incision reduction group were statistically different from that of closed reduction group （P〈 0.05）. The intraoperative fluoroscopy time, the nonunion occurrence rate, the incidence of the coxa vara and the incidence of internal fixation slipping of incision reduction group and closed reduction group had no difference （P〉0.05）. Conclusion The cannulated screw internal fixation can get ideal fracture effect, reduce the incidence of femoral head necrosis and obtain more ideal forward curative effect.

关 键 词：股骨颈骨折 切开复位 闭合复位 空心钉内固定 临床疗效 

分 类 号：R683.42[医药卫生—骨科学]