空心钉的不同构型与股骨颈骨折术后髋关节功能的关系研究  

Relationship between different configurations of hollow nails and hip joint function after surgery for femoral neck fracture

作　　者：谢学文[1] 赵崇智[1] 谭伟欣[1] 丁玲[1] 莫永辉[1] 许力科 Xie Xuewen;Zhao Chongzhi;Tan Weixin;Ding Ling;Mo Yonghui;Xu Like(Department of Orthopedics,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China)

机构地区：[1]佛山市中医院骨科,广东佛山528000

出　　处：《中华临床医师杂志（电子版）》2021年第6期439-444,共6页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探究空心钉不同构型与股骨颈骨折术后髋关节功能的关系。方法选择2015年10月至2019年8月于本院骨科行空心螺钉内固定治疗且资料完整的中青年股骨颈骨折患者158例,依据空心螺钉数量及构型分为正三角形组、倒三角形组及四边形组。随访时间超过半年,记录并比较3组患者手术时间、术中出血量、透视次数、住院时间、部分负重时间、骨折愈合时间、髋关节Harris评分及术后并发症发生情况。结果3组患者术中出血量、住院时间、骨折愈合时间无统计学差异(P>0.05),平均随访(20.77±7.84)个月。正三角形组、倒三角形组和四边形组患者手术时间分别为(57.84±13.44)、(53.77±10.56)、(79.45±11.65)min,透视次数分别为(19.22±7.85)、(18.49±9.46)、(27.82±7.66)次,四边形组均高于其余2组(P<0.05),正三角形组和倒三角形组之间无统计学差异(P>0.05)。四边形组部分负重时间[(9.27±1.88)周]短于其余2组[正三角形组:(12.06±1.47)周,倒三角形组:(11.87±1.55)周],差异有统计学意义(P<0.05),正三角形组和倒三角形组之间无统计学差异(P>0.05)。术后3个月后正三角形组、倒三角形组和四边形组患者Harris评分分别为(71.26±7.52)、(75.45±6.89)、(82.79±6.76)分,四边形组评分显著高于其余2组(P<0.05),正三角形组和倒三角形组之间无统计学差异(P>0.05)。3组患者末次随访Harris评分及总并发症发生率差异均无统计学意义(P>0.05)。结论空心螺钉治疗中青年股骨颈骨折临床疗效明确且螺钉构型及数量对骨折愈合及远期髋关节功能并无明显影响。Objective To explore the relationship between different configurations of hollow nails and hip joint function after femoral neck fracture surgery.Methods A total of 158 young and middle-aged femoral neck fracture patients who underwent hollow screw internal fixation in our hospital from October 2015 to August 2019 were selected.According to the number and configuration of hollow screws,they were divided into a normal triangle group,an inverted triangle group,and a quadrilateral group.The follow-up time was more than half a year.The operation time,blood loss,number of fluoroscopies,hospitalization time,time to partial weight bearing and fracture healing,Harris score of the hip joint,and postoperative complications were recorded and compared among the three groups.Results There were no significant differences in intraoperative blood loss,hospital stay,and time to fracture healing among the three groups(P>0.05),and the average follow-up time was(20.77±7.84)months.The operation time of the patients in the normal triangle group,inverted triangle group,and quadrilateral group were(57.84±13.44),(53.77±10.56)and(79.45±11.65)min,respectively;the number of fluoroscopies was(19.22±7.85),(18.49±9.46)and(27.82±7.66)times.The operation time was significantly longer and the number of fluoroscopies was significantly more in the quadrilateral group than in the other two groups(P<0.05),but there was no statistical difference between the normal triangle group and the inverted triangle group(P>0.05).The time to weight-bearing was significantly shorter in the quadrilateral group[(9.27±1.88)weeks]than in the other two groups[normal triangle gorup:(12.06±1.47)weeks,inverted triangle group:(11.87±1.55)weeks;P<0.05],though there was no statistical difference between the normal triangle group and the inverted triangle group(P>0.05).The Harris scores of patients in the normal triangle group,inverted triangle group,and quadrilateral group were(71.26±7.52),(75.45±6.89),and(82.79±6.76),respectively,at 3 months after surgery;the s

关 键 词：股骨颈骨折 空心螺钉 数量 构型 

分 类 号：R687.3[医药卫生—骨科学]