两种方法治疗青壮年股骨颈骨折的疗效比较  

Efficacy comparison of two kinds of methods for treatment of femoral neck fracture in young adults

作　　者：凡福成 张保[1] FAN Fu-cheng;ZHANG Bao(Dept of Orthopaedics,the Second People′s Hospital of Hefei,Hefei,Anhui 230000,China)

机构地区：[1]合肥市第二人民医院骨科,安徽合肥230000

出　　处：《临床骨科杂志》2023年第2期234-237,共4页Journal of Clinical Orthopaedics

摘　　要：目的 比较切开复位与闭合复位空心钉内固定治疗青壮年股骨颈骨折的疗效。方法 将66例青壮年股骨颈骨折患者按照随机数字表法分为切开复位组(采用切开复位空心钉内固定治疗)和闭合复位组(采用闭合复位空心钉内固定治疗),各33例。记录两组手术情况、骨折复位情况、骨折愈合情况、髋关节功能Harris评分及并发症发生情况。结果 患者均获得随访,时间34~36个月。手术时间切开复位组长于闭合复位组(P<0.05)。术中透视次数、骨折解剖复位率、骨折愈合时间、末次随访时髋关节功能Harris评分切开复位组均优于闭合复位组(P<0.05)。两组术后切口愈合良好,无皮缘坏死、皮肤及关节感染、双下肢深静脉血栓形成等并发症发生;随访期间未出现空心钉断钉、退钉等情况。结论 与闭合复位空心钉内固定相比,采用切开复位空心钉内固定治疗青壮年股骨颈骨折具有术中透视次数少、骨折复位效果好、骨折愈合快、髋关节功能恢复好、并发症少等优点,但手术时间较长。Objective To compare the effect of open reduction and closed reduction and cannulated screw internal fixation in the treatment of femoral neck fracture in young adults.Methods Sixty-six young adults with femoral neck fractures were divided into open reduction group(treated with open reduction and cannulated screw internal fixation)and closed reduction group(treated with closed reduction and cannulated screw internal fixation),according to the random number table method,with 33 cases in each group.The two groups were recorded for surgery condition,fracture reduction,fracture healing,Harris score of hip function and complications.Results All patients were followed up for 34~36 months.The surgical duration was longer in the open reduction group than that in the closed reduction group(P<0.05).The open reduction group was superior to closed reduction group in the times number of intraoperative fluoroscopy,the rate of anatomical fracture reduction,fracture healing time,and Harris score of hip function at the last follow-up(P<0.05).The postoperative incisions healed well in the two groups,and there were no complications such as skin margin necrosis,skin and joint infection,and deep vein thrombosis formation of both lower limbs.During the follow-up period,there were no breakage and withdraw of the cannulated screw.Conclusions Compared with closed reduction and cannulated screw internal fixation,the use of open reduction and cannulated screw internal fixation in the treatment of femoral neck fracture in young adults has the advantages of fewer intraoperative fluoroscopy,good fracture reduction effect,faster fracture healing,good hip function recovery and few complications,while the operation time is longer.

关 键 词：股骨颈骨折 切开复位 闭合复位 内固定 青壮年 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]