空心螺钉内固定并钻孔减压术治疗中青年人股骨颈骨折的临床效果  

Therapeutic effects of cannulated screw internal fixation and drilling decompression on femoral neck fractures in young and middle-aged patients

作　　者：赵国勇 崔冬 王怀林 ZHAO Guo-yong;CUI Dong;WANG Huai-lin(Orthopedics Department,Dancheng County People’s Hospital,Zhoukou 477150,China)

机构地区：[1]郸城县人民医院骨科

出　　处：《河南医学研究》2019年第23期4244-4247,共4页Henan Medical Research

摘　　要：目的评价空心螺钉内固定并钻孔减压术治疗中青年人股骨颈骨折的临床效果。方法回顾性分析2012年10月至2016年10月于郸城县人民医院骨一科接受手术治疗的64例中青年股骨颈骨折患者的临床资料,其中32例接受股骨颈骨折闭合复位空心螺钉内固定并钻孔减压术的患者纳入减压组,32例仅接受闭合复位空心螺钉内固定术治疗的患者纳入未减压组。对比两组患者术中出血量、手术时间、术后住院时间、完全负重时间,以及术后24个月髋关节Harris评分、骨折愈合率、股骨头坏死率。结果两组患者术中出血量、手术时间、术后住院天数、完全负重时间、髋关节Harris评分相比,差异无统计学意义(均P>0.05)。未减压组和减压组股骨颈骨折愈合率分别为84.38%(27/32)、93.75%(30/32),减压组股骨颈骨折愈合率高于未减压组,差异有统计学意义(P<0.05)。未减压组和减压组股骨头坏死率分别为15.63%(5/32)、6.25%(2/32),减压组股骨头坏死率低于未减压组,差异有统计学意义(P<0.05)。结论采用空心螺钉内固定并钻孔减压术治疗中青年人股骨颈骨折,可有效促进骨折愈合,减少股骨头坏死的发生。Objective To evaluate the therapeutic effects of cannulated screw internal fixation and drilling decompression on femoral neck fractures in young and middle-aged patients.Methods The clinical data of 64 young and middle-aged patients patients with femoral neck fractures who underwent surgery in Dancheng County People’s Hospital from October 2012 to October 2016 were retrospectively analyzed.Thirty-two patients who underwent cannulated screw internal fixation and drilling decompression were included in decompression group,and 32 patients who underwent cannulated screw internal fixation were included in no-decompression group.The intraoperative blood loss,operation time,postoperative hospital stay,full weight-bearing time,and Harris score,fracture healing rate,and femoral head necrosis rate after 24 months after the surgery were compared between the two groups.Results There was no significant difference in intraoperative blood loss,operation time,postoperative hospital stay,full weight-bearing time,and Harris score between the two groups(all P>0.05).The fracture healing rates in no-decompression group and decompression group were 84.38%(27/32)and 93.75%(30/32),respectively.The fracture healing rate in decompression group was higher than that in no-decompression group,and the difference was statistically significant(P<0.05).The femoral head necrosis rate was 15.63%(5/32)and 6.25%(2/32)in no-decompressed group and decompression group,respectively.The femoral head necrosis rate in decompression group was lower than that in no-decompression group,and the difference was statistically significant(P<0.05).Conclusion Cannulated screw internal fixation combined with drilling decompression could effectively promote the healing of femoral neck fractures in young and middle-aged people and reduce the occurrence of femoral head necrosis.

关 键 词：股骨颈骨折 中青年人 钻孔减压术 骨折愈合 股骨头坏死 

分 类 号：R658.3[医药卫生—外科学]