股骨颈动力交叉钉系统与空心加压螺钉治疗老年股骨颈骨折短期随访的对比  

Comparison of short-term follow-up results between femoral neck system and cannulated compressive screws in the treatment of femoral neck fracture in the elderly

作　　者：汪天豪 梁晓龙 郑恺 李荣群[1] 周军 耿德春[1] 徐耀增[1] 朱锋[1] Wang Tianhao;Liang Xiaolong;Zheng Kai;Li Rongqun;Zhou Jun;Geng Dechun;Xu Yaozeng;Zhu Feng(Department of Orthopedics,First Affiliated Hospital of Soochow University,Suzhou 215008,Jiangsu Province,China)

机构地区：[1]苏州大学附属第一医院骨科,江苏省苏州市215008

出　　处：《中国组织工程研究》2023年第36期5828-5833,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:股骨颈骨折是老年人常见的骨折,内固定治疗作为现在的主流治疗方式之一,仍需进一步追求坚强固定,尽可能减少并发症的发生。目的:比较股骨颈动力交叉钉系统和空心加压螺钉治疗老年股骨颈骨折的短期疗效。方法:回顾性分析2020年4月至2021年6月符合标准的35例老年股骨颈骨折患者资料,按治疗方法分为2组,股骨颈动力交叉钉系统组16例,空心加压螺钉组19例。两组患者的性别、年龄、受伤侧、受伤方式、骨折分型等一般资料差异无显著性意义。记录比较两组患者的手术时间、出血量、术后住院日、复位质量、愈合时间、Harris评分及术后并发症发生情况,分析两组疗效的差别。结果与结论:(1)16例股骨颈动力交叉钉系统组患者中除1例内固定失效,其余获得了8-25个月随访,平均11.9个月;19例空心加压螺钉组患者获得了7-26个月随访,平均16.3个月;(2)两组患者的手术时间、出血量、术后住院日、复位质量、骨折愈合时间、末次Harris评分及术后并发症均无显著性差异;(3)股骨颈动力交叉钉系统组术后1个月Harris评分优于空心加压螺钉组,差异有显著性意义(P=0.039);(4)股骨颈动力交叉钉系统组发生内固定失效1例,术后2个月行全髋关节置换,股骨颈短缩1例;空心加压螺钉组发生股骨颈短缩合并退钉1例;(5)提示在老年患者股骨颈骨折治疗上,股骨颈动力交叉钉系统和空心加压螺钉都有微创、快速、便于操作的优点,股骨颈动力交叉钉系统在早期康复中有更坚强的固定强度,允许患者早期负重,表现出更好的髋关节功能。BACKGROUND:Femoral neck fracture is a common fracture in the elderly.As one of the mainstream treatment methods,internal fixation is still needed to further pursue strong fixation and reduce the incidence of complications as much as possible.OBJECTIVE:To compare the short-term effectiveness of the femoral neck system and cannulated compressive screws for femoral neck fracture in elderly patients.METHODS:The clinical data of 35 elderly patients with femoral neck fractures who met the research criteria from April 2020 to June 2021 were retrospectively analyzed.They were divided into the femoral neck system group(16 cases)and cannulated compressive screw group(19 cases)according to different treatment methods.There were no statistical differences between the two groups in gender,age,injured side,injury mode,fracture classification and other general data.The operation time,blood loss,postoperative hospitalization days,reduction quality,healing time,Harris score and postoperative complications of the two groups were recorded and compared.The curative effect was analyzed between the two groups.RESULTS AND CONCLUSION:(1)16 patients with femoral neck system were followed up for 8-25 months(mean 11.9 months),except for 1 case of internal fixation failure.19 patients treated with cannulated compressive screws were followed up for 7-26 months(mean 16.3 months).(2)There was no significant difference between the two groups in operation time,blood loss,postoperative hospitalization days,reduction quality,healing time,last Harris score and postoperative complications.(3)The Harris score of the femoral neck system group was significantly better than that of cannulated compressive screw group 1 month after operation(P=0.039).(4)In the femoral neck system group,there was 1 case of internal fixation failure receiving total hip arthroplasty 2 months after operation and 1 case of femoral neck shortening.In the cannulated compressive screw group,there was 1 case of femoral neck shortening with the loosening of the screw.(5)It is indic

关 键 词：股骨颈骨折 股骨颈动力交叉钉系统 空心加压螺钉 老年患者 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R687