股骨颈动力交叉钉系统与倒三角形空心螺钉固定治疗成人股骨颈骨折的疗效比较  

A comparative study of femoral neck system versus inverted triangle cannulated compression screws in fixation of adult femoral neck fracture

作　　者：熊巍 易敏[1] 龙成 刘雷[1] 岑石强[1] 黄富国[1] 唐云峰 王光林[1] Xiong Wei;Yi Min;Long Cheng;Liu Lei;Cen Shiqiang;Huang Fuguo;Tang Yunfeng;Wang Guanglin(Department of Traumatic Orthopaedics,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院创伤骨科,成都610041

出　　处：《中华创伤骨科杂志》2021年第9期748-753,共6页Chinese Journal of Orthopaedic Trauma

基　　金：四川省科学技术厅科技计划项目(2018SZ0145,2018SZYZF0006)。

摘　　要：目的比较股骨颈动力交叉钉系统(FNS)和倒三角形空心螺钉(CCS)固定治疗成人股骨颈骨折的临床疗效。方法回顾性分析2019年9月至2020年6月期间四川大学华西医院创伤骨科收治的119例成年股骨颈骨折患者资料。根据内固定方式不同分为两组:FNS组62例,男38例,女24例;年龄为(54.0±13.0)岁;骨折Garden分型:Ⅱ型13例,Ⅲ型34例,Ⅳ型15例;采用FNS固定治疗。CCS组57例,男42例,女15例;年龄为(53.2±11.3)岁;骨折Garden分型:Ⅱ型9例,Ⅲ型33例,Ⅳ型15例;采用倒三角形CCS固定治疗。比较两组患者的手术时间、术中出血量、术中透视次数、住院时间、骨折愈合时间、髋关节Harris评分及并发症发生率等。结果两组患者术前一般资料及随访时间比较差异均无统计学意义(P>0.05),具有可比性。FNS组患者的术中透视次数[(8.8±2.9)次]显著少于CCS组患者[(15.6±3.4)次],手术时间[(45.2±10.1)min]和骨折愈合时间[(3.2±0.4)个月]显著短于CCS组患者[(51.8±11.7)min、(4.0±0.6)个月],末次随访时髋关节Harris评分[(91.8±4.4)分]显著高于CCS组患者[(84.6±3.3)分],末次随访时股骨颈短缩程度显著低于CCS组患者,差异均有统计学意义(P<0.05)。而两组患者的术中出血量、住院时间及并发症发生率等比较差异均无统计学意义(P>0.05)。结论与倒三角形CCS比较,FNS固定治疗成人股骨颈骨折可显著减少术中透视次数,减轻股骨颈短缩程度,缩短手术时间和骨折愈合时间,促进髋关节功能恢复。Objective To compare the clinical efficacy between femoral neck system(FNS)and inverted cannulated compression screws(ICCS)in the fixation of adult femoral neck fracture.Methods The clinical data were retrospectively analyzed of the 119 patients with femoral neck fracture who had received FNS or ICCS internal fixation at Department of Traumatic Orthopedics,West China Hospital from September 2019 to June 2020.They were divided into 2 groups according to their internal fixation methods.In the FNS group of 62 patients,there were 38 males and 24 females,with an age of(54.0±13.0)years,and 13 cases of typeⅡ,34 cases of typeⅢand 15 cases of typeⅣaccording to the Garden classification;in the ICCS group of 57 patients,there were 42 males and 15 females,with an age of(53.2±11.3)years,and 9 cases of typeⅡ,33 cases of typeⅢand 15 cases of typeⅣaccording to the Garden classification.The operation time,intraoperative blood loss,fluoroscopy frequency,hospitalization time,fracture healing time,Harris hip score and incidence of complications were compared between the 2 groups.Results The 2 groups were comparable due to insignificant differences in their preoperative general data or follow-up duration(P>0.05).There were significant differences between the FNS and ICCS groups in fluoroscopy frequency[(8.8±2.9)times versus(15.6±3.4)times],operation time[(45.2±10.1)min versus(51.8±11.7)min],fracture healing time[(3.2±0.4)months versus(4.0±0.6)months],Harris hip score at the last follow-up[(91.8±4.4)points versus(84.6±3.3)points],and femoral neck shortening at the last follow-up,favoring the FNS group(all P<0.05).There were no significant differences in follow-up time,hospitalization time,intraoperative blood loss or incidence of complications between the 2 groups(P>0.05).Conclusions In the fixation of adult femoral neck fractures,compared with ICCS,FNS can significantly reduce fluoroscopy frequency,shorten fracture healing and operation time,reduce risk of femoral neck shortening and hospitalization time,and pro

关 键 词：股骨颈骨折 骨折固定术 内 成年人 股骨颈动力交叉钉系统 

分 类 号：R687.3[医药卫生—骨科学]