闭合复位经皮4枚空心钉内固定治疗Pauwels Ⅲ型年轻股骨颈骨折的临床研究  

Clinical Research of Closed Reduction and Percutaneous Four Cannulated Screws Internal Fixation in the Treatment of Pauwels Type-Ⅲ Young Femoral Neck Fracture

作　　者：李刚[1] 黄品强[1] 杨勇[1] 高春洪[1] 刘智[1] Li Gang Huang Pinqiang Yang Yong et al(The TCM Hospital of Pinghu, Zhejiang 314200, China)

机构地区：[1]平湖市中医院,314200

出　　处：《医学研究杂志》2017年第9期91-95,150,共6页Journal of Medical Research

基　　金：浙江省平湖市科技计划项目[平科技(2015)36号]

摘　　要：目的观察闭合复位经皮4枚空心钉内固定治疗PauwelsⅢ型年轻股骨颈骨折的临床疗效。方法 2007年1月~2013年12月,随访60例PauwelsⅢ型年轻股骨颈骨折,分为治疗组与对照组各30例,治疗组采用闭合复位经皮4枚空心钉内固定,对照组采用经皮3枚空心钉内固定。通过Garden复位指数评估总体闭合复位质量;比较两组患者骨折愈合时间,髋关节Harris评分与并发症(骨折不愈合,股骨头坏死,股骨颈短缩,螺钉松动和返修手术)发生情况等方面的区别。结果 60例患者Garden复位指数Ⅰ、Ⅱ级优良复位率达88.33%。治疗组患者股骨颈骨折全部愈合,对照组4例不愈合,两组愈合患者中骨折愈合时间比较差异有统计学意义(P<0.05),治疗组骨折愈合时间较对照组短;两组Harris评分比较差异有统计学意义(P<0.05),治疗组Harris评分较对照组高。两组并发症发生情况比较差异有统计学意义(P<0.05),治疗组在骨折不愈合、股骨头坏死、股骨颈短缩、螺钉松动和返修手术的病例均少于对照组。结论闭合复位经皮4枚空心钉内固定技术,能为PauwelsⅢ型年轻股骨颈骨折提供精准复位和稳定的内固定方式,可以最大限度的改善临床功能,减少并发症的发生。Objective To observe the clinical therapeutic effect of closed reduction and percutaneous four eannulated screws internal fixation in the treatment of Pauwels type - Ill young femoral neck fracture. Methods From January 2007 to December 2013, 60 cases of Pauwels type - III young femoral neck fracture were followed up and divided into treatment group and control group of 30 cases. Treatment group was treated by closed reduction and percutaneous cannulated screw internal fixation in 4, and 3 in control group with percutaneous cannulated screw fixation. The overall closed reduction quality was evaluated by Garden reduction index, and the differences were com- pared between the two groups in fracture healing time, Harris hip score and complications （nonunion, femur head necrosis, femoral neck shortening, screw loosening, and revision surgery）. Results The excellent reduction rate with Garden reduction index I and II grade was 88.33% in the 60 cases of patients. All the patients with femoral neck fracture of the treatment group were healing. Four cases of control group were not healing. The fracture healing time in the two groups of healing patients had significant difference（P 〈 0.05 ）. Fracture healing time of treatment group was shorter than the control group. The Harris score of the two groups had significant difference （P 〈 0. 05）. Treatment group Harris score was higher than the control group. The complications of the two groups had significant difference （ P 〈 0.05 ）. The treatment group cases were less than the control group in fracture nonunion, femur head necrosis, femoral neck shorten- ing, screw loosening and revision surgery. Conclusion Closed reduction and percutaneous four cannulated screws internal fixation tech- nique, can provide accurate reduction and stable internal fixation for Pauwels type - III young femoral neck fracture, can maximize the im- provement of clinical function, and reduce the incidence of complications.

关 键 词：股骨颈骨折 内固定 闭合复位 空心钉 

分 类 号：R683.42[医药卫生—骨科学]