切开复位空心钉内固定联合带血管蒂骨瓣移植治疗GardenⅢ和Ⅳ型股骨颈骨折疗效分析  

Clinical Efficacy of Open Reduction and Cannulated Screw Internal Fixation Combined with Vascular⁃pedicled Bone Grafting in the Treatment of Femoral Neck Fracture of Graden StageⅢandⅣ

作　　者：崔伟宾 刘永亮 CUI Weibin;LIU Yongliang(Department of Orthopedics,Zhengzhou Economic and Technological Development Zone Jiulong Hospital,Zhengzhou,Henan 450016,China)

机构地区：[1]郑州经济技术开发区九龙医院骨科,河南郑州450016

出　　处：《中国烧伤创疡杂志》2023年第5期392-395,共4页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的探究切开复位空心钉内固定联合带血管蒂骨瓣移植治疗GardenⅢ和Ⅳ型股骨颈骨折的临床疗效-方法选取2019年1月至2020年7月郑州经济技术开发区九龙医院收治的92例GardenⅢ和Ⅳ型股骨颈骨折患者作为研究对象,根据不同手术方式将其分为观察组(46例)与对照组(46例),观察组患者于患肢肿胀基本消除后行切开复位空心钉内固定联合带血管蒂骨瓣移植治疗,对照组患者于患肢肿胀基本消除后行闭合复位空心钉内固定治疗,对比观察两组患者术后负重行走时间、骨折复位质量、髋关节功能及并发症发生情况-结果观察组患者术后负重行走时间明显短于对照组(t=3.173,P=0.002);术后12周,观察组患者骨折复位质量为Ⅰ级36例、Ⅱ级8例、Ⅲ级1例、Ⅳ级1例,明显优于对照组患者的骨折复位质量为Ⅰ级24例、Ⅱ级12例、Ⅲ级6例、Ⅳ级4例(Z=-2.804,P=0.005);术后3、6、12个月,观察组患者Harris评分均明显高于对照组(t=3.481、3.443、4.778,P均<0.001);术后随访12个月,观察组患者并发症发生率为4.35%,明显低于对照组患者的并发症发生率17.39%(χ^(2)=4.039,P=0.044)-结论切开复位空心钉内固定联合带血管蒂骨瓣移植治疗GardenⅢ和Ⅳ型股骨颈骨折,可明显改善骨折复位质量,提高髋关节功能恢复效果,降低并发症发生风险.Objective To analyze the clinical efficacy of open reduction and cannulated screw internal fixation combined with vascular-pedicled bone grafting in the treatment of femoral neck fracture of Garden stageⅢandⅣ.Methods 92 patients with femoral neck fracture of Garden stageⅢandⅣadmitted into Zhengzhou Economic and Technological Development Zone Jiulong Hospital between January 2019 and July 2020 were enrolled as research subjects,and divided into study group(n=46)and control group(n=46)based on different surgical methods they received.When the swellingof the affected limbs was basically subsided,patients in the study group were treated with the open reduction and cannulated screw internal fixation plus vascular-pedicled bone grafting,while patients were treated with the closed reduction and cannu-lated screw internal fixation in the control group.The time of postoperative weight-bearing walking,reduction quality of fracture,functions of hip joint and occurrence of complications of patients were compared between the two groups.Results The time of postoperative weight-bearing walking of patients was obviously shorter in the study group compared with the control group(t=3.173,P=0.002).12 weeks after surgery,the reduction quality of fracture was evaluated as gradeⅠin 36 cases,gradeⅡin 8 cases,gradeⅢin 1 case and gradeⅣin 1 case in the study group,which was obviously better than that in the control group(Z=-2.804,P=0.005)-gradeⅠin 24 cases,gradeⅡin 12 cases,gradeⅢin 6 cases and gradeⅣin 4 cases.Respectively on month 3,6 and 12 after surgery,the Harris scores of patients in the study group were all markedly higher than that in the control group(t=3.481,3.443 and 4.778,all P<0.001).During the follow-up 12 months after surgery,the incidence of complications was 4.35%in the study group,being significantly lower than the corresponding 17.39%in the control group(χ^(2)=4.039,P=0.044).Conclusion In the treatment of femoral neck fracture of Garden stageⅢandⅣ,the open reduction and cannulated screw int

关 键 词：切开复位空心钉内固定 闭合复位空心钉内固定 带血管蒂骨瓣移植 股骨颈骨折 髋关节功能 

分 类 号：R687.3[医药卫生—骨科学]