两种内固定方式治疗股骨颈骨折的疗效比较  

Comparison efficacy of two internal fixation in the treatment of femoral neck fracture

作　　者：徐鹏辉 仇道迪 滕加文[2] 卞泗善[2] 金垚 XU Peng-hui;QIU Dao-di;TENG Jia-wen;BIAN Si-shan;JIN Yao(The First Clinical Medical College of Shandong University of TCM,Jinan,Shandong 250014,China;Dept of Microorthopedics,the Affiliated Hospital of Shandong University of TCM,Jinan,Shandong 250014,China)

机构地区：[1]山东中医药大学第一临床医学院,山东济南250014 [2]山东中医药大学附属医院显微骨科,山东济南250014

出　　处：《临床骨科杂志》2023年第3期387-390,共4页Journal of Clinical Orthopaedics

基　　金：山东省自然科学基金面上项目(编号:ZR2020MH359)。

摘　　要：目的比较股骨颈复合加压系统(CCS)和倒三角空心钉(ITCS)内固定治疗股骨颈骨折的疗效。方法将50例股骨颈骨折患者按照内固定方式不同分为观察组(采用CCS固定治疗,25例)和对照组(采用ITCS固定治疗,25例)。记录两组手术时间、术中出血量、骨折愈合时间、拄双拐下地时间。采用Harris评分评价髋关节功能恢复情况。结果患者均获得随访,时间5~7个月。骨折均解剖复位。切口无感染,均一期愈合。手术时间、术中出血量两组比较差异均无统计学意义(P>0.05);骨折愈合时间观察组明显短于对照组(P<0.05)。拄双拐下地时间:44例(观察组23例,对照组21例)于术后1.5个月,6例(观察组2例,对照组4例)于术后2.0个月。术后3个月Harris评分观察组明显高于对照组(P<0.05)。结论CCS和ITCS固定治疗股骨颈骨折均可获得满意疗效,但CCS固定治疗具有骨折愈合时间快、患者可早期功能锻炼、髋关节功能恢复较好的优势。Objective To compare the efficacy of femoral neck compound compression system(CCS)and inverted triangle cannulated screw(ITCS)fixation in the treatment of femoral neck fracture.Methods According to different surgical methods,50 patients with femoral neck fractures were divided into observation group(CCS fixation treatment,25 cases)and control group(ITCS fixation treatment,25 cases).The operation time,intraoperative blood loss,fracture healing time and ambulation time with double crutches were recorded in the two groups.Harris score was used to evaluate the recovery of hip function.Results All patients were followed up for 5~7 months.All fractures were anatomically reduced.There was no incisions infection and they all healed in one-stage.There were no significant differences in operation time and intraoperative blood loss between the two groups(P>0.05).Fracture healing time in observation group was significantly shorter than the control group(P<0.05).The ambulation time with double crutches:44 cases(23 cases in the observation group and 21 cases in the control group)were 1.5 months after operation,6 patients(2 cases in the observation group and 4 cases in the control group)were 2.0 months after operation.At 3 months after operation,Harris score in observation group was significantly higher than that in control group(P<0.05).Conclusions In the treatment of femoral neck fracture,CCS and ITCS fixation can achieve satisfactory results.However,CCS fixation treatment has the advantages of faster fracture healing time,early functional exercise for patients and better hip function recovery.

关 键 词：股骨颈骨折 复合加压系统 倒三角空心钉 

分 类 号：R683.42[医药卫生—骨科学] R687.3[医药卫生—外科学]