股骨颈动力交叉钉系统治疗Pauwels Ⅱ、Ⅲ型股骨颈骨折的疗效  

Efficacy of femoral neck system in treatment of PauwelsⅡandⅢfemoral neck fractures

作　　者：党修亭 郑峰[2] 马玉林 张涛 沈万熙 DANG Xiuting;ZHENG Feng;MA Yulin;ZHANG Tao;SHEN Wanxi(Graduate School of Qinghai University,Xining,Qinghai 810016,China)

机构地区：[1]青海大学研究生院,青海西宁810016 [2]青海省人民医院骨科,青海西宁810007

出　　处：《中国临床研究》2023年第10期1540-1544,共5页Chinese Journal of Clinical Research

基　　金：青海省基础研究计划项目(2020-ZJ-755)。

摘　　要：目的 对比在PauwelsⅡ、Ⅲ型股骨颈骨折患者中采用股骨颈动力交叉钉系统(FNS)和空心螺钉进行内固定治疗的疗效。方法 回顾性分析青海省人民医院骨科2020年1月至2021年12月收治的64例18~65岁的PauwelsⅡ、Ⅲ型股骨颈骨折患者资料。内固定治疗采用FNS的29例为FNS组,采用空心加压螺钉的35例为空心螺钉组。记录并比较两组患者的住院时间、手术时间、术中出血量、术中透视次数、术后负重时间、骨折愈合时间、髋关节Harris评分及并发症发生情况等。结果 两组患者的一般资料及住院时间、手术时间差异无统计学意义(P>0.05)。FNS组患者术中出血量高于空心螺钉组,术中透视次数、术后负重时间、骨折愈合时间均低于空心螺钉组,差异有统计学意义(P<0.05)。末次随访时,两组患者髋关节功能Harris评分差异无统计学意义(P>0.05)。两组患者切口均愈合良好,随访期间均未出现切口感染、骨折不愈合、内固定失效、股骨头坏死等并发症。结论 FNS治疗PauwelsⅡ、Ⅲ型股骨颈骨折在术中透视次数、术后下地负重时间和骨折愈合时间方面优于空心螺钉,患者可以尽早下地负重训练,对骨折的愈合和髋关节功能的恢复具有较大帮助。Objective To compare the curative effect of internal fixation with femoral neck system(FNS)and cannulated compression screw(CCS)in patients with PauwelsⅡandⅢfemoral neck fractures.Methods The clinical data of 64 patients with PauwelsⅡandⅢfemoral neck fractures aged 18-65 years who were admitted to Qinghai Provincial People s Hospital from January 2020 to December 2021 were retrospectively analyzed.Twenty-nine cases using FNS for internal fixation treatment were in FNS group,and 35 cases using CCS were in CCS group.The hospitalization time,operation time,intraoperative blood loss,the number of intraoperative X-ray fluoroscopy,postoperative weight-bearing time,fracture healing time,Harris Hip Score and the occurrence of complications were compared between two groups.Results There was no significant difference on the general data and hospitalization time and operation time between two groups(P>0.05).The intraoperative blood loss in FNS group was higher than that in CCS group,while the number of intraoperative X-ray fluoroscopy,postoperative weight-bearing time and fracture healing time were less than those in CCS group,with statistical significance(P<0.05).At the last follow-up,there was no significant difference in Harris Hip Score between two groups(P>0.05).The incisions healed well in both groups,and there was no complication such as incision infection,fracture nonunion,internal fixation failure,and necrosis of the femoral head during the follow-up period.Conclusion FNS treatment of PauwelsⅡandⅢfemoral neck fractures is significantly better than CCS treatment in terms of the number of intraoperative X-ray fluoroscopy,the time of weight bearing and fracture healing after operation.Patients can be trained with weight-bearing as soon as possible,which is helpful for fracture healing and hip function recovery.

关 键 词：股骨颈骨折 PauwelsⅡ型 PauwelsⅢ型 股骨颈动力交叉钉系统 空心螺钉 内固定 

分 类 号：R683.42[医药卫生—骨科学]