DAA入路空心钉联合内侧支撑钢板治疗青壮年PauwelsⅢ型股骨颈骨折  

Treatment of Pauwels TypeⅢFemoral Neck Fracture in Young Adults with DAA Approach Cannulated Screw Combined with Medical Supporting Plate

作　　者：李贤科 钱增杰[1] 陈庚[1] 王晓辉 张平[1] 蔡彬[1] 张长虹[1] LI Xian-ke;QIAN Zeng-jie;CHEN Geng;WANG Xiao-hui;ZHANG Ping;CAI Bin;ZHANG Chang-hong(The First Orthopedic Department,Zhongwu Hospital,Suqian,Jiangsu 223800,China)

机构地区：[1]宿迁市钟吾医院骨1科,江苏宿迁223800

出　　处：《湖北医药学院学报》2022年第1期52-56,共5页Journal of Hubei University of Medicine

摘　　要：目的:观察直接前方入路(direct anterior approach,DAA)空心钉联合内侧支撑钢板治疗青壮年股骨颈PauwelsⅢ型骨折的疗效。方法:回顾性分析2017年6月至2020年1月我院收治的40例青壮年股骨颈骨折患者的临床资料。根据不同内固定方式分为空心钉辅助内侧支撑钢板组(试验组)和单纯空心钉组(对照组)。比较两组手术时间、术中出血量、术后骨折愈合情况、髋关节功能、复位质量及术后并发症情况。结果:对照组出血量(65.2±29.6)mL,少于试验组(285.4±127.8)mL;对照组手术时间(70.8±16.9)min,短于试验组(123.3±12.5)min;试验组骨折愈合时间(5.9±1.3)个月,短于对照组(4.4±1.1)个月,差异均具有统计学意义(P<0.05)。试验组术后骨折复位质量高,且试验组术后6个月Harris评分为(90.95±4.87)分,高于对照组(81.65±5.24)分,术后并发症少,两组比较差异有统计学意义(P<0.05)。结论:空心钉联合内侧支撑钢板应用于青壮年PauwelsⅢ型股骨颈骨折,具有骨折复位质量更高、术后并发症发生率更低,髋关节功能恢复更好等优点,值得临床推广应用。Objective To observe the effect of direct anterior approach(DAA)cannulated screw combined with medial support plate in the treatment of young and middle-aged femoral neck Pauwels type III fractures.Methods The clinical data of 40 young adults patients with Pauwels typeⅢfemoral neck fractures from June 2017 to January 2020 were retrospectively analyzed.According to different internal fixation methods,they were divided into cannulated screw-assisted medial support plate group(test group)and cannulated screw group(control group).The operation time,intraoperative blood loss,postoperative fracture healing,hip joint function,reduction quality and postoperative complications were compared between the two groups.Results The bleeding volume of the control group was(65.2±29.6)mL,which was less than that of the experimental group(285.4±127.8 mL).The operation time of the control group was(70.8±16.9)min,which was shorter than that of the experimental group(123.3±12.5 min).The fracture healing time of the experimental group was(5.9±1.3)months,which was shorter than that of the control group(4.4±1.1 months),and the difference was statistically significant(P<0.05).The quality of postoperative fracture reduction in the experimental group was high,and the Harris score in the experimental group was(90.95±4.87)six months after operation,which was higher than that in the control group(81.65±5.24).There were fewer postoperative complications.There was significant difference between the two groups(P<0.05).Conclusion Cannulated screw combined with medial support plate in young and middle-aged Pauwels III femoral neck fracture has the advantages of higher fracture reduction quality,lower postoperative complication rate,and better hip function recovery,which is worthy of clinical application.

关 键 词：股骨颈骨折 PauwelsⅢ型股骨颈骨折 内侧支撑钢板 空心钉 

分 类 号：R687.3[医药卫生—骨科学]