经皮加压钢板与空心钉治疗股骨颈骨折的临床疗效比较  

Clinical curative effect of percutaneous compression plating and cannulated screw for treatment of femoral neck fractures

作　　者：叶俊星[1] 戴涟生[1] 王松华[1] 张斌[1] 杨晓斐[1] 吴红富[1] 程飞[1] 杨志刚[1] 袁凤来[1] 

机构地区：[1]江苏省无锡市第三人民医院,江苏无锡214000

出　　处：《中国现代医学杂志》2017年第19期45-48,共4页China Journal of Modern Medicine

基　　金：国家自然科学基金(No:82170011);江苏省自然科学基金(No:BK20151114)

摘　　要：目的比较经皮加压钢板和空心螺钉治疗股骨颈骨折的临床疗效。方法选取2012~2015年来该院采用经皮加压钢板(PCCP)治疗股骨颈骨折病例32例,与同期采用空心螺钉固定的股骨颈骨折32例进行随访比较。PCCP组,男性14例,女性18例;平均年龄42.5岁(27~59岁);车祸伤20例,跌伤10例,高处坠落伤2例;均为闭合性骨折,无明显合并症;Garden分型,Ⅰ型3例,Ⅱ型5例,Ⅲ18例,Ⅳ型6例。空心钉组,男性20例,女性12例;平均年龄43.3岁(23~61岁);车祸伤22例,跌伤10例;均为闭合性骨折,无明显合并症;Garden分型,Ⅰ型4例,Ⅱ型9例,Ⅲ17例,Ⅳ型2例。对两组患者的手术时间、住院时间、骨折愈合时间、Harris髋关节功能评分进行比较,并进行统计学分析。结果两组患者住院时间、骨折愈合时间、Harris髋关节功能评分比较,差异无统计学意义(P>0.05),但PCCP组并发症更少,差异有统计学意义(P<0.05)。结论 PCCP可使骨折端加压,但又控制过度压缩,钉板结合可防止颈干角丢失,两枚螺钉固定具有抗旋转能力,是治疗股骨颈骨折的一种疗效确切的方法。Objective To compare the clinical effect of percutaneous compression plate （PCCP） and cannulated screw for treatment of femoral neck fractures. Methods From 2012 to 2015, 32 cases of femoral neck fracture were treated with PCCP （PCCP group） and 32 cases were treated with cannulated screw （cannulated screw group） in our hospital. In the PCCP group, there were 14 males and 18 females with the average age of 42.5 y; the patients had closed fractures due to traffic accidents （20 cases）, tumble （10 cases）, or falling from height （2 cases） without obvious complications; for Garden typing, there were 3 cases of type Ⅰ, 5 cases of type Ⅱ, 18 cases of type Ⅲ and 6 cases of type Ⅳ. In the cannulated screw group, there were 20 males and 12 females with the average age of 43.3 y; the patients had closed fractures due to traffic accident （22 cases） or tumble （10 cases）, there were no obvious complications; for Garden typing, there were 4 cases of type I, 9 cases of type Ⅱ, 17 cases of type Ⅲand 2 cases of type Ⅳ. The operation time, duration of hospital stay, fracture healing time and Harris hip function score were compared between the two groups, and statistical analyses were performed. Results The hospital time, fracture healing time and Harris hip function score had no statistical differences between the two groups （P〉 0.05）; but the PCCP group had fewer complications than the cannulated screw group （P〈 0.05）. Conclusions PCCP can pressurize the fracture ends, but avoid excessive compression. Nail and plate combination can prevent the loss of neck stem angle. Two -screw fixation can resist rotation. Therefore, PCCP is an effective curative method for the treatment of femoral neck fracture.

关 键 词：股骨颈骨折 经皮加压钢板 空心螺钉 

分 类 号：R683[医药卫生—骨科学]