Singh指数对老年股骨颈骨折内固定术后疗效影响  

Effect of Singh index on the treatment of femoral neck fractures fixed by internal fixation in elderly patients

作　　者：杨文斌[1] 张二洋 冯阳阳[3] 杨益宏[1] 倪建龙[2] 

机构地区：[1]西安高新医院骨一科,陕西西安710075 [2]西安交通大学第二附属医院骨一科,陕西西安710004 [3]延安大学附属医院骨一科,陕西延安716000

出　　处：《临床军医杂志》2017年第4期405-408,共4页Clinical Journal of Medical Officers

摘　　要：目的应用Singh指数评价空心螺钉内固定术治疗老年股骨颈骨折的术后疗效。方法选取西安高新医院收治的因股骨颈骨折的老年患者58例,按照Singh指数随机分成非骨质疏松组(A组)28例和骨质疏松组(B组)30例,均行空心螺钉内固定术,记录每例患者的手术时间、术中出血量情况,并根据Harris髋关节功能评分系统对术后功能进行比较。结果所有患者均获得12个月随访。两组患者手术时间、术中出血量比较,差异无统计学意义(P>0.05)。A组术后骨折不愈合5例,其中,发生股骨头坏死2例,总体成功率为82.1%(23/28);B组术中内固定失败并选用人工股骨头置换术4例,术后骨折不愈合8例,其中,出现股骨头缺血性坏死5例,总体成功率为60.0%(12/30),两组总体成功率比较,差异有统计学意义(P<0.05);末次随访,两组患者Harris评分优良率比较,差异有统计学意义(P<0.05)。结论 Singh指数法是一种经济、方便、有效的骨密度测定方法,可用于评价空心螺钉内固定术治疗老年股骨颈骨折的术后疗效。Objective To investigate the clinical value in elderly patients with femoral neck fractures fixed by hollow screw internal fixation using Singh index. Methods A retrospective study was performed on 58 patients with femoral neck fracture who were admitted in Xi＇an Gao Xin Hospital. According to Singh index,patients were randomly divided into the non-osteoporosis group（ Group A,n =28） and osteoporosis group（ Group B,n = 30）. Patients received hollow screw internal fixation,the operate time,the bleeding during operation were recorded,and the function of hip joint was evaluated by Harris assessment system. Results All patients were followed-up for a year. The operate time and the bleeding during operation had not statistically significant difference（ P〉0. 05）. In Group A,there were 5 cases of nonunion after surgery,including 2 cases of femoral head necrosis,the total effective rate was 82. 1%（ 23/28）; In Group B,there were 4 cases of internal fixation failure occurred,8 cases of nonunion after surgery,including 5 cases of avascular necrosis of the femoral head,the overall success rate was 60. 0%（ 12/30）,the overall success rate of the two groups had statistically significant difference（ P〈0. 05）; last follow-up,the difference of Harris score between the two groups was statistically significant（ P〈0. 05）. Conclusion Singh index method is an economical,convenient and effective method for bone mineral density measurement,which can be used to evaluate the efficacy of the treatment of hollow screw internal fixation in elderly patients with femoral neck fractures.

关 键 词：SINGH指数 股骨颈骨折 内固定术 老年 

分 类 号：R681[医药卫生—骨科学]