闭合复位空心螺钉固定联合自体红骨髓移植治疗股骨颈骨折的疗效观察  

Effect of closed reduction and hollow screw fixation combined with autologous red bone marrow transplantation with medullary decompression on femoral neck fracture

作　　者：谢涛江 蓝勇波[1] 张彤[1] 孙川江[1] 刘斐文[1] XIE Tao-jiang;LAN Yong-bo;ZHANG Tong(Department of Orthopedics,Pangang Group General Hospital,Panzhihua Sichuan 617000,China)

机构地区：[1]攀钢集团总医院骨科,四川攀枝花617000

出　　处：《临床和实验医学杂志》2018年第13期1419-1421,共3页Journal of Clinical and Experimental Medicine

基　　金：四川省教育厅自然科学一般项目(编号:15ZB0187)

摘　　要：目的研究闭合复位空心螺钉固定联合自体红骨髓移植治疗股骨颈骨折的疗效。方法回顾性选取2014年1月至2016年12月收治的股骨颈骨折患者57例,分为对照组29例,观察组28例。对照组进行闭合复位空心螺钉固定,观察组联合自体红骨髓移植进行治疗。比较两组临床疗效、康复指标(包括住院时间、肉芽组织生长时间、创面封闭时间、感染控制时间、骨折愈合时间)、Harris评分及并发症发生情况。结果观察组的优良率(92.86%)明显高于对照组(72.41%),差异有显著性(P<0.05)。观察组的住院时间、肉芽组织生长时间、创面封闭时间、感染控制时间、骨折愈合时间均显著低于对照组(P<0.05);术后1年,观察组的Harris评分显著高于对照组(P<0.05);观察组并发症发生率7.14%(2/28)显著低于对照组20.69%(6/29)(P<0.05)。结论闭合复位空心螺钉固定联合自体红骨髓移植是治疗股骨颈骨折的有效方法 ,可以有效提高患者的髋关节功能,缩短骨折愈合时间,降低并发症的发生率。Objective To investigate the clinical effect of closed reduction and hollow screw fixation combined with autologous red bone marrow transplantation on femoral neck fracture. Methods Fifty-seven cases of patients with femoral neck fracture who were treated from January 2014 to December 2016 were divided into control group and observation group by treatment methods,each of 29,28 cases. The control group was treated with closed reduction and hollow screw fixation,and the observation group was treated with autologous red bone marrow transplantation.The clinical therapeutic effects,rehabilitation indicators（ including hospital stay,growth time of granulation tissue,wound closure time,infection control time,fracture healing time）,Harris scores and complications were compared between the two groups. Results After treatment,the effective rate of the observation group was 92. 86%（ 26/28）,significantly higher than that of the control group 72. 41%（ 21/29）（ P〈0. 05）. The growth time of granulation tissue,the time of fracture healing,the time of infection control,the time of hospitalization and the sealing time of the wound were significantly shorter in the observation group than in the control group（ P〈0. 05）. The function,pain,range of activity and malformation of Harris in the observation group were significantly higher than those in the control group（ P〈0. 05）. The incidence of femoral head necrosis and coxa varus in the observation group was 7. 14%（ 2/28）,which was significantly lower than that of the control group 20. 69%（ 6/28）（ P〈0. 05）. Conclusion Closed reduction and hollow screw fixation combined with autologous red bone marrow transplantation is an effective methods for treatment of femoral neck fractures,which can effectively improve the hip function,shorten fracture healing time and reduce complications.

关 键 词：股骨颈骨折 闭合复位空心螺钉固定 自体红骨髓移植 

分 类 号：R687.3[医药卫生—骨科学]