股骨颈动力交叉钉系统与空心螺钉固定治疗中青年股骨颈骨折的近期疗效比较  

Comparison of short-term efficacy between femoral neck system and cannulated compression screws in treatment of femoral neck fractures

作　　者：常廷杰 葛宇峰 高峰 曹奇勇[1] 赵春鹏[1] 王贵 吴新宝[1] Chang Tingjie;Ge Yufeng;Gao Feng;Cao Qiyong;Zhao Chunpeng;Wang Gui;Wu Xinbao(Department of Orthopaedics and Traumatology,Beijing Jishuitan Hospital,Peking University Fourth School of Clinical Medicine,Beijing 100035,China;Department of Orthopaedics,Heping Hospital Affiliated to Changzhi Medical College,Changzhi 046000,China;Department of Orthopaedics,Hainan Western Central Hospital,Danzhou 571700,China)

机构地区：[1]北京大学第四临床医学院,北京积水潭医院创伤骨科,北京100035 [2]山西省长治医学院附属和平医院骨科,长治046000 [3]海南西部中心医院骨科,儋州571700

出　　处：《中华创伤骨科杂志》2022年第6期533-537,共5页Chinese Journal of Orthopaedic Trauma

基　　金：北京市科委计划项目(2201100005420033)。

摘　　要：目的比较股骨颈动力交叉钉系统(FNS)和空心螺钉(CCS)固定治疗中青年股骨颈骨折的近期疗效。方法回顾性分析2020年1月至12月期间北京积水潭医院创伤骨科采用FNS治疗的29例中青年股骨颈骨折患者资料。根据性别、年龄、体重指数匹配29例采用CCS治疗的患者,并据此分为两组:CCS组29例,男14例,女15例;年龄为(48.2±12.3)岁;采用CCS固定;FNS组29例,男14例,女15例;年龄为(48.2±12.0)岁;采用FNS固定。比较两组患者的骨折复位质量、手术时间、术中出血量、末次随访时股骨颈短缩程度、髋关节功能、Barthel指数、健康调查12条简表(SF-12)评分及随访期间并发症发生情况等。结果两组患者术前一般资料及随访时间比较差异均无统计学意义(P>0.05),具有可比性。CCS组患者的术中出血量[20(10,50)mL]显著少于FNS组患者[50(20,50)mL],末次随访时股骨颈短缩程度(1级5例,2级18例,3级6例)显著重于FNS组患者(1级21例,2级6例,3级2例),差异均有统计学意义(P<0.05)。而两组患者的骨折复位质量、手术时间、随访期间并发症发生率、末次随访时Merle d'Aubigné&Postel评分、Barthel指数及SF-12量表评分比较差异均无统计学意义(P>0.05)。结论对于中青年股骨颈骨折,FNS和CCS都是较好的内固定选择。与CCS比较,FNS可显著减轻患者的股骨颈短缩程度,更好地维持股骨颈长度。Objective To compare the short-term efficacy between femoral neck system(FNS)and cannulated compression screws(CCS)in the treatment of femoral neck fractures in young and middle-aged patients.Methods A retrospective study was performed of the 29 young and middle-aged patients with femoral neck fracture who had been treated with FNS at Department of Orthopaedics and Traumatology,Beijing Jishuitan Hospital from January 2020 to December 2020.A control group of another 29 patients with femoral neck fracture was selected who had been treated with CCS but matched in gender,age,and body mass index.In the CCS group,there were 14 males and 15 females with an age of(48.2±12.3)years;in the FNS group,there were 14 males and 15 females with an age of(48.2±12.0)years.The fracture reduction quality,operation time,intraoperative blood loss,and femoral neck shortening,hip joint function,Barthel index and health survey 12-item short form(SF-12)score at the last follow-up and complications during follow-up were compared between the 2 groups.Results No significant difference was found in the preoperative general data or follow-up time between the 2 groups,showing comparability(P>0.05).The intraoperative blood loss in the CCS group[20(10,50)mL]was significantly less than that in the FNS group[50(20,50)mL],and the femoral neck shortening at the last follow-up in the CCS group(grade 1 in 5 cases;grade 2 in 18 cases and grade 3 in 6 cases)was significantly worse than that in the FNS group(grade 1 in 21 cases,grade 2 in 6 cases and grade 3 in 2 cases)(P<0.05).No significant difference was found regarding fracture reduction quality,operation time,complications during follow-up,or Merle D'Aubigne Postel score,Barthel index or SF-12 score at the last follow-up(P>0.05).Conclusions In the treatment of femoral neck fractures in young and middle-aged patients,both FNS and CCS are good options for internal fixation.However,FNS can reduce the severity of femoral neck shortening and maintain the length of femoral neck better than CCS.

关 键 词：股骨颈骨折 骨折固定术 内 骨钉 股骨颈动力交叉钉系统 

分 类 号：R687.3[医药卫生—骨科学]