空心钉结合内侧支撑钢板在PauwelsⅢ型股骨颈骨折中的应用  

Cannulated Screws Combined with Medial Buttress Plate in the Treatment of Pauwels TypeⅢFemoral Neck Fracture

作　　者：沈正清[1] 谢景凌 王旭东[1] 王俊鸿[1] 肖志满[1] 刘斌伟[1] Shen Zhengqing;Xie Jingling;Wang Xudong(Department of Orthopaedics,Jinjiang Municipal Hospital of Fujian Province,Jinjiang 362200,China)

机构地区：[1]福建省晋江市医院骨科,福建晋江362200

出　　处：《实用骨科杂志》2021年第3期205-209,共5页Journal of Practical Orthopaedics

基　　金：泉州市卫生健康委科研资助项目(201817)。

摘　　要：目的研究空心钉结合内侧支撑钢板在PauwelsⅢ型股骨颈骨折治疗中的应用效果。方法2015年11月至2018年10月,选取符合纳入标准的PauwelsⅢ型股骨颈骨折患者58例,随机分为空心钉、空心钉结合内侧支撑钢板两组,每组各29例。观察和比较两组患者平均手术时间、术中出血量、术中透视次数、骨折复位质量、术后并发症(如退钉、骨不连、股骨头坏死率、髋内翻、股骨颈短缩等),术后6、12、24个月Harris评分评定髋关节功能情况。结果患者均获随访,随访时间24~56个月,平均(30.6±6.1)个月。(1)与空心钉组比较,空心钉结合钢板组的平均手术时间更长、术中出血量更多,但术中透视次数少,两组比较差异均有统计学意义(P<0.05)。(2)空心钉结合钢板组骨折复位优良率高,两组比较差异有统计学意义(P<0.05)。(3)空心钉结合钢板组术后退钉、股骨头坏死、髋内翻、股骨颈短缩等并发症的发生率均低于空心钉组,两组比较差异有统计学意义(P<0.05),术后骨不连发生率两组相当,差异无统计学意义(P>0.05)。(4)与空心钉组比较,空心钉结合钢板组在术后6、12、24个月的Harris评分明显更高,差异有统计学意义(P<0.05)。结论空心钉结合内侧支撑钢板在PauwelsⅢ型股骨颈骨折治疗中的疗效较好,术后并发症发生率低,可为临床治疗该类型骨折提供参考。Objective To study the application of cannulated screw combined with medial buttress plate in the treatment of Pauwels typeⅢfemoral neck fracture.Methods From November 2015 to October 2018,58 patients with Pauwels typeⅢfemoral neck fractures who met the inclusion criteria wereenrolled and randomly divided into two groups:cannulated screw,cannulated screwscombined with medial buttress plate,with 29 cases in each group.The average operation time,intraoperative blood loss,intraoperative fluoroscopy,postoperative complications(such as nail removal,nonunion,femoral head necrosis rate,hip varus,femoral neck shortening,etc.)were observed and compared between the two groups.Harris Hip Score at 6,12and 24 months after operation were used to assess hip joint function.Results All patients were followed up 24~56 months,with an average of(30.6±6.1)months.(1)Compared with the cannulated screw group,the average operation time and intraoperative blood loss of the cannulated screwcombined with medial buttress plate group were longer and more,but the time of intraoperative fluoroscopy was less,and the difference was statistically significant(P<0.05).(2)The excellent and good rate of fracture reduction in cannulated screwcombined with medial buttress plate group is high,and the difference is statistically significant.(3)The incidence of postoperative complications such as screw withdrawal,femoral head necrosis,hip varus,and femoral neck shortening in cannulated screw combined withmedial buttress plate group was lower than that of the cannulated screw group,and the difference was statistically significant(P<0.05).The incidence of nonunion was similar between the two groups,and the difference was not statistically significant(P>0.05).(4)Compared with the cannulated screw group,the Harris Hip Score of the cannulated screw combined with medial buttress plate group was significantly higher at 6,12,and 24 months after surgery,and the difference was statistically significant.(P<0.05).Conclusion Cannulated screw combined with medial b

关 键 词：股骨颈骨折 空心钉 内侧支撑钢板 

分 类 号：R683.42[医药卫生—骨科学]