空心钉联合内侧buttress钢板治疗PauwelsⅢ型青少年股骨颈骨折近期疗效分析  

Analysis of recent clinical efficacy of medial buttress plate combined with cannulated compression screw in treatment of Pauwels typeⅢadolescent femoral neck fracture

作　　者：程龙 吴学建[1] CHEN Long;WU Xue-jian(Department of Orthopaedics,The First Addiliated Hospital of Zhengzhou University,,Zhenzghou 450052,China)

机构地区：[1]郑州大学第一附属医院骨科,郑州450052

出　　处：《医药论坛杂志》2020年第3期50-53,共4页Journal of Medical Forum

摘　　要：目的观察空心加压螺钉联合内侧buttress钢板治疗PauwelsⅢ型青少年股骨颈骨折的近期疗效。方法回顾性分析2014年1月至2017年1月本院收治的48例PauwelsⅢ型青少年股骨颈骨折患者,根据内固定方式分为两组,A组(n=25)采用3枚空心加压钉内固定;B组(n=23)采用3枚空心加压钉联合内侧buttress钢板内固定,术后定期复查、随访。比较两组患者手术切口长度、手术时间、术中出血量、术后髋关节harris评分、VAS评分、garden指数及术后并发症。结果所有患者均获得随访,随访时间12~18个月。①A组手术时间、术中出血量均小于B组(P<0.05),两组手术切口长度比较无明显差异(P>0.05);②B组术后各时点髋关节harris评分均高于A组(P<0.05);③两组术前VAS评分比较无明显差异(P>0.05),B组术后各时点VAS评分均低于A组(P<0.05);④两组术后初次正侧位片garden指数比较无明显差异(P>0.05),B组术后6个月正侧位片garden指数明显高于A组(P<0.05);⑤B组术后并发症发生率低于A组(P<0.05)。结论采用空心钉联合内侧buttress钢板治疗PauwelsⅢ型青少年股骨颈骨折能获得并维持满意复位,内固定强度高,术后功能恢复好,利于患者预后康复。Objective Observe the recent clinical efficacy of medial buttress plate combined with cannulated compression screw in the treatment of Pauwels typeⅢadolescent femoral neck fracture.Methods Retrospective analysis of 48 cases of PauwelsⅢadolescent femur-neck fractures treated in our hospital from January 2014 to January 2017.These patients were divided into two groups according to different intra-surgical fixation methods,25 cases in Group A were treated with three hollow compression screws,and 23 cases in Group B were treated with medial buttress plate combined with three hollow compression screws.All patients were reviewed,followed up regularly.Compare the length of the incision,the operation time,and the amount of intraoperative blood loss,postoperative hip function Harris Score,VAS Score,Garden Index and Postoperative Complications.Results All patients were followed up for 12-18 months.①The operating time and intraoperative blood loss in Group A patients were lower than in Group B(P<0.05).There was no significant difference in the length of the incision with two groups.②Harris Score in group A was lower than group B at all points in time after surgery(P<0.05).③There was no significant difference in the preoperative VAS Score of the two groups(P>0.05).The VAS Score in group B was lower than group A at all points in time after surgery(P<0.05).④There was no significant difference between the postoperative initial positive and side X-ray Garden Index of the two groups of patients after surgery(P>0.05).positive and side X-ray Garden Index in group B was higher than group A in 6 months after surgery(P<0.05).⑤The incidence of postoperative complications was lower in Group B than in Group A(P<0.05).Conclusion Medial buttress plate combined with cannulated compression screws treatment Pauwels typeⅢadolescent femoral neck fracture can obtain and maintain satisfactory reset,with high internal fixed strength and good postoperative function recovery,that is beneficial to the patient’s prognostic recovery.

关 键 词：Pauwels Ⅲ型股骨颈骨折 内固定 骨折复位 青少年 

分 类 号：R274.12[医药卫生—中医骨伤科学]