DAA切开复位联合大粗隆抗剪切螺钉治疗青年PauwelsⅢ型股骨颈骨折的临床效果  

Clinical efficacy of DAA open reduction combined with greater trochanter anti-shear screw in treatment of Pauwels type Ⅲ femoral neck fractures in youth

作　　者：邓建海 郭新丽 Deng Jianhai;Guo Xinli(Henan Provincial Veterans Hospital,Xinxiang,Henan 453000,China)

机构地区：[1]河南省荣军医院骨科,新乡453000

出　　处：《河南外科学杂志》2021年第6期41-43,共3页Henan Journal of Surgery

摘　　要：目的探讨直接前侧入路(DAA)切开复位联合大粗隆抗剪切螺钉对青年PauwelsⅢ型股骨颈骨折的疗效。方法回顾性分析2019-01—2020-01河南省荣军医院骨科收治的94例PauwelsⅢ型股骨颈骨折患者的临床资料。分为DAA切开复位联合大粗隆抗剪切螺钉组(观察组,50例)与闭合复位空心螺钉固定组(对照组,44例)。比较2组骨折完全愈合时间、术后12个月内的并发症(骨折不愈合、内固定失效、股骨头坏死)。统计术后3个月、6个月、12个月时2组患者骨折复位Garden指数、Harris髋关节功能评分量表(HHS)评分。结果观察组患者骨折完全愈合时间短于对照组,术后12个月内并发症发生率低于对照组,差异均有统计学意义(P<0.05)。术后3个月、6个月、12个月时,2组患者的Garden指数差异均无统计学意义(P>0.05)。术后3个月、6个月时,观察组患者的HHS评分高于对照组,差异均有统计学意义(P<0.05)。结论 DAA切开复位联合大粗隆抗剪切螺钉治疗青年PauwelsⅢ型股骨颈骨折,可促进术后骨折愈合、改善其髋关节功能,术后并发症发生率低。Objective To investigate the efficacy of direct anterior approach(DAA)incision and reduction combined with large thick augmentation anti-shear screw on young type PauwelsⅢfemoral neck fracture.Methods The clinical data of 94 patients with type PauwelsⅢfemoral neck fracture admitted to the Orthopedics of Henan Veterans Hospital from 2019-01 to 2020-01 were retrospectively analyzed.It was divided into DAA incision reduction combined with large thick-long antishear screw group(observation group,50 cases)and closed reduction hollow screw fixation group(control group,44 cases).Compare the complete healing time of fracture in group 2 and postoperative complications within 12 months(fracture failure,internal fixation failure,necrosis of the femoral head).Statistical fracture reduction Garden index and Harris Hip Functional Score Scale(HHS)scores in group 2 patients at 3,6,and 12 months after surgery.Results The observed group had the shorter complete fracture healing time than that of the control group,and the lower incidence of complications within 12 months than that of the control group,which were statistically significant(P<0.05).No significant difference in the Garden index was observed at 3,6,and 12 months after surgery(P>0.05).At 3 and 6 months after surgery,the HHS score was higher than that of the observation group,which was statistically significant(P>0.05).Conclusion DAA incision reduction combined with large thick augmentation anti-shear screw for young type PauwelsⅢfemoral neck fracture can promote postoperative fracture healing and improve its hip function,with a low incidence of postoperative complications.

关 键 词：直接前侧入路 大粗隆抗剪切螺钉 青年 PauwelsⅢ型 股骨颈骨折 疗效 

分 类 号：R683.42[医药卫生—骨科学]