股骨颈动力交叉钉系统与空心螺钉固定治疗青壮年股骨颈骨折的近期疗效比较  

A comparative study of short-term clinical effects between femoral neck system and cannulated compression screws in treatment of femoral neck fractures in young adults

作　　者：杨家赵 周雪锋 朱万博 李黎[1] 徐玮 夏睿 王刚[2] 华兴一[2] 许新忠[3] 方诗元 徐磊[1] Yang Jiazhao;Zhou Xuefeng;Zhu Wanbo;Li Li;Xu Wei;Xia Rui;Wang Gang;Hua Xingyi;Xu Xinzhong;Fang Shiyuan;Xu Lei(Department of Orthopaedics,The First Affiliated Hospital to University of Science and Technology of China(Anhui Provincial Hospital),Hefei 230001,China;Department of Orthopaedics,The First Affiliated Hospital to Anhui Medical University,Hefei 230022,China;Department of Orthopaedics and Traumatology,The Second Affiliated Hospital to Anhui Medical University,Hefei 230601,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)骨科,合肥230001 [2]安徽医科大学第一附属医院骨科,合肥230022 [3]安徽医科大学第二附属医院创伤骨科,合肥230601

出　　处：《中华创伤骨科杂志》2021年第9期761-768,共8页Chinese Journal of Orthopaedic Trauma

基　　金：安徽省科技攻关计划项目(1401045022);安徽省立医院医疗领先技术项目(2020LXJS)。

摘　　要：目的比较股骨颈动力交叉钉系统(FNS)与空心螺钉(CCS)固定治疗青壮年股骨颈骨折的近期临床疗效。方法回顾性分析2019年10月至2020年10月期间安徽省立医院骨科、安徽医科大学第一附属医院骨科及第二附属医院创伤骨科收治的94例股骨颈骨折患者资料。根据内固定方式不同分为两组:FNS组47例,男30例,女17例;年龄为(47.8±9.8)岁;采用FNS固定治疗。CCS组47例,男26例,女21例;年龄为(43.7±13.1)岁;采用多枚CCS固定治疗。比较两组患者的手术时间、切口长度、术中出血量、骨折愈合时间、术后负重时间、髋关节Harris评分及并发症发生情况等。结果两组患者术前一般资料及随访时间的比较差异均无统计学意义(P>0.05),具有可比性。FNS组患者的手术时间[(47.7±9.4)min]显著短于CCS组患者[(66.1±3.8)min],术后部分和完全负重时间[2.0(2.0,3.0)、(6.4±2.1)周]显著早于CCS组患者[8.0(3.0,9.0)、(10.1±3.4)周],骨折愈合时间[3.0(3.0,4.0)个月]显著短于CCS组患者[3.0(3.0,4.0)个月],末次随访时髋关节Harris评分[95.0(93.0,95.0)分]显著高于CCS组患者[90.0(88.0,95.0)分],大腿外侧激惹发生率[0%(0/47)]显著低于CCS组患者[31.9%(15/47)],股骨颈短缩长度[(4.3±3.9)mm]显著短于CCS组患者[(6.9±4.5)mm],差异均有统计学意义(P<0.05)。而两组患者的股骨头缺血性坏死及内固定失效发生率比较差异均无统计学意义(P>0.05)。结论与CCS比较,FNS固定治疗青壮年股骨颈骨折可缩短手术时间和骨折愈合时间,并允许患者术后早期离床活动,有利于股骨颈长度的维持和髋关节功能的恢复。Objective To compare short-term clinical efficacy between femoral neck system(FNS)and cannulated compression screws(CCS)in the treatment of femoral neck fractures in young adults.Methods Retrospectively analyzed were the data of 94 patients with femoral neck fracture who had been admitted to Department of Orthopedics and Traumatology,The First Affiliated Hospital to University of Science and Technology of China,Department of Orthopaedics,The First Affiliated Hospital to Anhui Medical University and Department of Orthopaedics,The Second Affiliated Hospital to Anhui Medical University from October 2019 to October 2020.They were divided into 2 groups according to their modes of internal fixation:a FNS group(n=47)and a CCS group(n=47).In the FNS group there were 30 males and 17 females with a mean age of(47.8±9.8)years;in the CCS group there were 26 males and 21 females with a mean age of(43.7±13.1)years.The 2 groups were compared in terms of operation time,incision length,intraoperative blood loss,fracture healing time,weight-bearing time,Harris hip score and complications.Results There was no significant difference in preoperative general data or follow-up duration between the 2 groups,showing comparability between groups(P>0.05).In the FNS group,operation time[(47.7±9.4)min]was significantly shorter than that in the CCS group[(66.1±3.8)min],postoperative partial and full weight-bearing time[2.0(2.0,3.0)weeks,(6.4±2.1)weeks]significantly earlier than that in the CCS group[8.0(3.0,9.0),(10.1±3.4)weeks],fracture healing time[3.0(3.0,4.0)months]significantly shorter than that in the CCS group[3.0(3.0,4.0)months],Harris hip score at the last follow-up[95.0(93.0,95.0)points]significantly higher than that in the CCS group[90.0(88.0,95.0)points],incidence of lateral thigh irritation[0%(0/47)]significantly lower than that in the CCS group[31.9%(15/47)],and neck shortening length(4.3±3.9 mm)significantly shorter than that in the CCS group(6.9±4.5 mm)(all P<0.05).There was no significant difference in the rate of ava

关 键 词：股骨颈骨折 骨折固定术 内 骨钉 手术后并发症 青壮年 

分 类 号：R687.3[医药卫生—骨科学]