切开与闭合复位空心钉内固定对移位股骨颈骨折患者骨折复位质量和髋关节功能的影响  

The Effect of Open and Closed Reduction and Internal Fixation with Cannulated Screws on the Reduction Quality and Hip Joint Function of Displaced Femoral Neck Fractures

作　　者：李若杨 李宁鑫 杜秀鹏 古金山 杨朝晖[1] LI Ruo-yang;LI Ning-xin;DU Xiu-peng;GU Jin-shan;YANG Zhao-hui(Department of Orthopaedics,The Second Hospital of Shanxi Medical University,Taiyuan,Shanxi,030001,China)

机构地区：[1]山西医科大学第二医院骨科,山西太原030001

出　　处：《现代生物医学进展》2021年第8期1494-1497,共4页Progress in Modern Biomedicine

基　　金：山西省留学人员科研资助项目(2013-114)。

摘　　要：目的:探讨切开与闭合复位空心钉内固定对移位股骨颈骨折患者骨折复位质量和髋关节功能的影响。方法:本研究为回顾性研究,选取98例移位股骨颈骨折患者的临床资料,根据手术方式的不同将患者分为A组(n=50,切开复位)和B组(n=48,闭合复位),比较两组患者优良率、骨折复位质量、髋关节功能、围术期指标、术后并发症发生率和二次手术发生率。结果:A组患者术后6个月的优良率为78.00%(39/50),高于B组的58.33%(28/48)(P<0.05)。两组术后负重下地时间、术中透视时间比较无差异(P>0.05);B组手术时间、住院时间短于A组,术中出血量少于A组(P<0.05)。两组患者术后1个月、术后3个月、术后6个月髋关节功能Harris评分均较术前升高,且A组高于B组(P<0.05)。两组二次手术及并发症发生率比较无差异(P>0.05)。A组Ⅰ型、Ⅱ型的例数均多于B组,Ⅲ型例数少于B组(P<0.05)。结论:与闭合复位空心钉内固定相比,切开复位空心钉内固定虽损伤较大,但其术后骨折复位质量和髋关节功能改善效果更佳,且不增加并发症发生率和二次手术发生率。Objective: To investigate the effect of open and closed reduction and internal fixation with cannulated screws on the reduction quality and hip joint function of displaced femoral neck fractures. Methods: This was a retrospective study, the clinical data of 98 patients with displaced femoral neck fracture were selected. According to the different operation methods, the patients were divided into group A(n=48, open reduction) and group B(n=50, closed reduction). The excellent rate, fracture reduction quality, hip joint function, perioperative index, postoperative complication rate and secondary operation rate of the two groups were compared. Results: The excellent and good rate of group A was 78.00%(39/50), which was higher than 58.33%(28/48) of the control group(P<0.05). There were no significant differences in fluoroscopy time in operation and weight-bearing time after operation between the two groups(P>0.05).The operation time and hospitalization time of group B were shorter than that of group A, the amount of bleeding in operation was less than that in group A(P<0.05). The Harris score of hip joint function in the two groups at 1 month, 3 months and 6 months after operation were higher than that before operation, and the score in group A was higher than that in group B(P<0.05). There were no significant differences in the secondary operation rate incidence and complication rate between the two groups(P>0.05). The number of type Ⅰ and type Ⅱ cases of group A was more than that of group B, and the number of type Ⅲ cases was less than that of group B(P<0.05). Conclusion: Compared with closed reduction and internal fixation with cannulated screw, open reduction has more damage, but it has better quality of fracture reduction and hip joint function, and does not increase the incidence of complications and secondary operation.

关 键 词：切开复位 闭合复位 空心钉内固定 移位股骨颈骨折 骨折复位质量 髋关节功能 

分 类 号：R683[医药卫生—骨科学]