强斜低位空心钉联合缝匠肌骨瓣治疗移位型股骨颈骨折的疗效观察  

Efficacy of Strong Oblique Low-position Hollow Screw Combined with Sartorius Muscle Flap in Treatment of Displaced Femoral Neck Fracture

作　　者：段宏波 任辉 吴昊 DUAN Hongbo;REN Hui;WU Hao(Department of Orthopedics,Qinhuangdao Workers′Hospital,Qinghuangdao 066200,China)

机构地区：[1]秦皇岛市工人医院骨科,河北秦皇岛066200

出　　处：《医学综述》2020年第21期4337-4341,共5页Medical Recapitulate

基　　金：秦皇岛市重点研发计划科技支撑项目(201703A139)。

摘　　要：目的观察强斜低位空心钉联合缝匠肌骨瓣治疗移位型股骨颈骨折(FNF)的有效性与安全性。方法选择2017年2月至2019年2月秦皇岛市工人医院骨科收治的106例移位型FNF患者作为研究对象,根据骨折治疗术式的不同分为对照组和研究组,每组53例。对照组给予平行加压空心钉内固定治疗,研究组给予强斜低位空心钉联合缝匠肌骨瓣治疗。比较两组手术指标(切口长度、手术时间、术中失血量)、术后指标[采用视觉模拟评分(VAS)评价术后24 h疼痛情况]及术前、术后1个月、3个月、6个月髋关节功能(采用Harris髋关节功能评分标准评价),并统计术后各不良事件发生率与死亡率。结果两组切口长度比较差异无统计学意义(P> 0.05);研究组手术时间长于对照组[(85.02±9.54) min比(72.51±10.52) min]、术中失血量多于对照组[(165.02±11.17) m L比(125.52±10.12) m L]、术后24 h VAS评分低于对照组[(3.96±1.11)分比(5.21±1.02)分](P <0.01)。髋关节功能Harris评分组间与时点间交互作用差异有统计学意义(P <0.01),术后1个月、3个月、6个月,两组髋关节功能Harris评分均较术前升高(P <0.05),且研究组髋关节功能Harris评分均高于对照组(P <0.05)。研究组术后不良事件发生率低于对照组[13.21%(7/53)比30.19%(16/53)](P <0.05);两组死亡率比较差异无统计学意义(P> 0.05)。结论对移位型FNF患者采取强斜低位空心钉联合缝匠肌骨瓣治疗,相比常规加压空心钉内固定治疗,虽然手术时间延长、术中失血量增多,但切口长度未发生明显变化,手术微创性也未受影响,且患者术后无明显疼痛感,髋关节功能恢复效果增强,不良事件发生率低,安全性好。Objective To observe the effectiveness and safety of strong oblique low-position hollow screw combined with sartorius muscle flap in the treatment of displaced femoral neck fracture(FNF).Methods A total of 106 patients with displaced FNF admitted to Department of Orthopedics,Qinhuangdao Workers’ Hospital from Feb.2017 to Feb.2019 were included in the study.They were divided into a control group and a research group according to different surgical procedures,with 53 cases in each group.The control group was treated with routine paralleled compression hollow screw internal fixation,and the research group was treated with strong oblique low-position hollow screw combined with sartorius muscle flap.Surgical indicators(incision length,operation time,amount of intraoperative blood loss) and postoperative indicators[using visual analog scale(VAS) to evaluate 24 h postoperative pain]and hip function before operation,and 1 month,3 months and 6 months after operation(using Harris hip function score standard to evaluate) of the two groups were compared,and the incidence of adverse events and mortality after surgery were recorded.Results The incision lengths of the two groups were not statistically significant(P > 0.05);the operation time of the research group was longer than that of the control group[(85.02 ± 9.54) min vs(72.51 ± 10.52) min],and the amount of intraoperative blood loss was more than that of the control group[(165.02 ± 11.17) m L vs(125.52 ± 10.12) m L],however,VAS score was lower than that of the control group(3.96 ± 1.11 vs 5.21 ± 1.02)(P < 0.01).There was statistically significant differences in the Harris score of hip function interactions of groups and time points(P < 0.01).1 month,3 months,and 6 months after operation,the Harris scores of hip function in both groups were higher than those before operation in the two groups(P < 0.05),and the Harris score of the hip function in the research group was higher than that in the control group(P < 0.05).The incidence of postoperative adverse events in t

关 键 词：移位型股骨颈骨折 强斜低位空心钉 缝匠肌骨瓣 疼痛程度 髋关节功能 

分 类 号：R687.3[医药卫生—骨科学]