闭合复位经皮空心钉内固定术中空心钉数量对股骨颈患者骨折力学稳定性及功能恢复的影响  

Effects of the number of cannulate screws on fracture mechanics stability and functional recovery in patients with femoral neck fractures during closed reduction and percutaneous cannulate screw internal fixation

作　　者：蒙永晖 马平 莫贵康 黄国财 MENG Yong-hui;MA Ping;MO Gui-kang;HUANG Guo-cai(Department of Orthopedics,Hezhou Guangji Hospital,Hezhou 542899,Guangxi,China)

机构地区：[1]贺州广济医院骨科,广西贺州542899

出　　处：《川北医学院学报》2023年第10期1379-1382,1395,共5页Journal of North Sichuan Medical College

基　　金：广西壮族自治区贺州市科学研究与技术开发计划项目(贺科技1407022)。

摘　　要：目的:探讨闭合复位经皮空心钉内固定术中空心钉数量对股骨颈骨折(FNF)患者骨折力学稳定性及髋关节功能恢复的影响。方法:选取110例闭合复位经皮空心钉内固定术的FNF患者为研究对象。根据术中植入空心钉数量分为A组(n=47)和B组(n=63),A组植入2枚空心钉;B组植入3枚空心钉。比较两组手术情况、骨折恢复情况和手术前后生活质量、骨折力学稳定性、髋关节功能恢复情况及并发症发生率。结果:B组手术时间、术中出血量、X线透视次数大于A组,骨折愈合时间短于A组(P<0.05);术后12个月,B组简明健康调查量表(SF-36)、力学稳定性评分均高于A组(P<0.05);术后1、6、12个月,B组Harris评分均高于A组(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:闭合复位经皮空心钉固定术中植入3枚空心钉可改善FNF患者骨折力学稳定性,促进关节功能恢复。Objective:To explore the effects of the number of cannulate screws on fracture mechanics stability and functional recovery in patients with femoral neck fractures(FNF)during closed reduction and percutaneous cannulate screw internal fixation.Methods:110 patients with FNF undergoing closed reduction and percutaneous cannulate screw internal fixation were enrolled.According to implanted number of cannulate screws,they were divided into group A(n=47,2 screws)and group B(n=63,3 screws).The surgical situations,fracture recovery,quality of life,fracture mechanics stability,recovery of hip function and incidence of complications were compared between the two groups before and after surgery.Results:The operation time,intraoperative blood loss and times of X-ray fluoroscopy in group B were higher than those in group A,and fracture healing time was shorter than that in group A(P<0.05).At 12 m after surgery,scores of the 36-item shot-form health status survey(SF-36)and mechanics stability in group B were higher than those in group A(P<0.05).At 1,6,and 12 m after surgery,Harris scores in group B were higher than those in group A(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Implanting three cannulate screws in closed reduction and percutaneous cannulate screw internal fixation can improve fracture mechanics stability and promote the recovery of joint function in FNF patients.

关 键 词：闭合复位经皮空心钉内固定术 空心钉数量 股骨颈骨折 骨折力学稳定性 髋关节功能 

分 类 号：R687.3[医药卫生—骨科学]