三枚空心钉与动力交叉钉系统固定治疗股骨颈骨折的临床疗效对比  

Comparative observation on the curative effect of femoral neck fixation with three cannulated screws and FNS fixation in the treatment of femoral neck fractures

作　　者：黄小东 陶岳峰[1] 朱炳斌 何健 房江月 江兵[1] 马军[1] Huang Xiaodong;Tao Yuefeng;Zhu Bingbin;He Jian;Fang Jiangyue;Jiang Bing;Ma Jun(Department of Orthopedics,Trauma Center of Anqing Municipal Hospital,Anhui Anqing 246003,China)

机构地区：[1]安徽省安庆市立医院创伤中心骨科,安徽安庆246003

出　　处：《中国医刊》2023年第2期179-182,共4页Chinese Journal of Medicine

基　　金：安徽省卫健委基金项目(AHWJ2021b117)。

摘　　要：目的 比较三枚空心钉(cannulated compression screw,CCS)固定与股骨颈动力交叉钉系统(femoral neck dynamic cross-screw system,FNS)固定治疗股骨颈骨折的临床效果。方法 回顾性分析2019年1月至2021年12月安徽省安庆市立医院收治的42例股骨颈骨折患者的临床资料,根据内固定方式的不同分为CCS组(20例,采用三枚CCS内固定)和FNS组(22例,采用FNS内固定),比较两组患者的手术时间、术中出血量、骨折愈合时间、术后负重时间、股骨颈缩短长度、髋关节功能Harrris评分及并发症发生情况等。结果 FNS组术中出血量明显高于CCS组,手术时间、透视次数明显低于CCS组,差异均有显著性(P<0.05)。FNS组术后负重时间、骨折愈合时间及股骨颈缩短长度明显短于CCS组,术后6个月髋关节功能Harris评分明显高于CCS组,差异均有显著性(P<0.05)。术后随访CCS组中2例发生内固定失效,1例出现断钉并发展为股骨头缺血性坏死,而FNS组无相关并发症发生。结论 CCS内固定及FNS内固定均是股骨颈骨折较好的选择,且相较于CCS,FNS内固定具有手术时间短、操作简单、透视次数少的优点,并能减少股骨颈短缩长度、缩短骨愈合时间,有利于髋关节功能的恢复。Objective To compare the clinical effects of femoral neck three-cannulated compression screw(CCS) fixation and femoral neck dynamic cross-screw system(FNS) fixation in the treatment of femoral neck fractures. Method A total of 42 patients with femoral neck fractures who were hospitalized in Anqing Municipal Hospital from January 2019 to December 2021 were selected as the research subjects, and divided into CCS group(31 cases) and FNS group(31 cases) with different internal fixation methods, and CCS group Three CCS were used for fixation, and the FNS group was treated with FNS fixation. The intraoperative blood loss, operation time, fracture healing time, incision length, postoperative weight-bearing time, hip Harris score, and postoperative shortening of the affected limb were compared between the two groups. Result Both groups were followed up for 6-18 months. The intraoperative blood loss in the FNS group was significantly higher than that in the CCS group(P<0.05). The number of fluoroscopy and fracture healing time in the FNS group were significantly lower than those in the CCS group, and the operation time was significantly shorter than that in the CCS group(P<0.05). The Harris score at 6 months was significantly higher than that in the CCS group(P<0.05), and the postoperative weightbearing time(partial and complete) and the shortened length of the femoral neck were significantly shorter than those in the CCS group(P<0.05). There were 3 complications during follow-up. There were 2 cases of three CSS fixation failure within 2 months after fixation,and re-hospitalization for artificial joint replacement surgery;1 patient had broken nails in the recovery stage after CSS fixation, and developed ANFH, which was treated by hip arthroplasty, the postoperative recovery was good. Conclusion In the case of good reduction of femoral neck fracture, both CCS fixation and FNS fixation are more suitable internal fixation options. Compared with CCS fixation, FNS has the advantages of shorter operation time, simpler operation

关 键 词：股骨颈骨折 三枚空心钉固定 股骨颈动力交叉钉系统固定 

分 类 号：R683.42[医药卫生—骨科学]