不同固定方式对股骨颈基底部骨折的影响  

Influence of Different Fixation Methods on Femoral Neck Base Fracture

作　　者：高榅青 GAO Wenqing(Jian’ou Municipal Hospital,Jian’ou 353100,China)

机构地区：[1]建瓯市立医院,福建建瓯353100

出　　处：《中外医学研究》2022年第13期112-115,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:比较微创闭合复位经皮空心加压螺丝钉固定术和股骨近端抗旋髓内钉(PFNA)固定术对股骨颈基底部患者的影响。方法:回顾性分析2016年10月-2019年10月建瓯市立医院治疗的150例股骨颈基底部骨折患者的临床资料。根据治疗方式的不同将其分为对照组(72例)和观察组(78例)。对照组给予微创闭合复位经皮空心加压螺丝钉固定术,观察组给予PFNA固定术。比较两组围手术期指标、术后随访1年髋关节功能,术前、术后7 d炎症因子及并发症。结果:两组手术时间和术中出血量比较差异均无统计学意义(P>0.05),观察组术后卧床时间和骨折愈合时间均短于对照组(P<0.05)。术后随访1年,观察组优良率高于对照组(P<0.05)。术后7 d,两组白细胞介素-1β(IL-1β)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)水平均高于术前(P<0.05),观察组IL-1β、IL-8和TNF-α水平均低于对照组(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论:PFNA固定术对股骨颈基底部骨折的效果更为明显,更有利于髋关节功能的恢复,临床上值得推广。Objective:To compare the influence of minimally invasive closed reduction and hollow compression screw fixation and proximal femoral nail antirotation (PFNA) fixation on patients with femoral neck base fracture.Method:The clinical data of 150 patients with femoral neck base fracture treated in Jian’ou Municipal Hospital from October 2016 to October 2019 were retrospectively selected.They were divided into control group (72 cases) and observation group (78 cases) according to different treatment methods.The control group was given the minimally invasive closed reduction and percutaneous hollow compression screw fixation,and the observation group was given the PFNA fixation.The perioperative indexes,hip joint function 1 year follow-up after surgery,inflammatory factors before and 7 days after operation and complications were compared between the two groups.Result:There were no significant differences in operation time and intraoperative bleeding volume between the two groups (P>0.05).The postoperative bed rest time and fracture healing time of the observation group were shorter than those of the control group (P<0.05).After 1 year of follow-up after surgery,the excellent and good rate of the observation group was higher than that of the control group (P<0.05).Seven days after operation,the levels of interleukin-1β (IL-1β),interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α) in the two groups were higher than those before operation (P<0.05),and the levels of IL-1β,IL-8 and TNF-α in the observation group were lower than those in the control group (P<0.05).There was no significant differences in the incidence of complications between the two groups (P>0.05).Conclusion:PFNA fixation has more obvious effect on femoral neck base fracture,with higher safety,and it is more conducive to the recovery of hip joint function,which is worthy of promotion in clinic.

关 键 词：股骨颈骨折 空心加压螺丝钉 股骨近端抗旋髓内钉 疗效 安全性 

分 类 号：R687.3[医药卫生—骨科学]