倒“品”字形空心钉与动力髋关节螺钉结合空心钉内固定治疗中青年股骨颈Garden Ⅲ型骨折疗效对比分析  

Comparison of the efficacy of inverted“pin”shaped cannulated screws and dynamic hip screw combined with cannulated screw internal fixation in the treatment of Garden typeⅢfemoral neck fracture in young and middle-aged patients

作　　者：马翔宇 刘兵 杨超 元红 周大鹏 韩天宇 MA Xiang-yu;LIU Bing;YANG Chao;YUAN Hong;ZHOU Da-peng;HAN Tian-yu(Department of Orthopedics,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院骨科,辽宁沈阳110016

出　　处：《创伤与急危重病医学》2023年第5期339-342,共4页Trauma and Critical Care Medicine

基　　金：辽宁省民生科技计划项目(2021JH2/10300057);沈阳市科技计划公共卫生研发专项(22-321-32-07)。

摘　　要：目的 比较倒“品”字形空心钉与动力髋关节螺钉(DHS)结合空心钉内固定治疗中青年股骨颈Garden Ⅲ型骨折的临床疗效。方法 选取自2015年1月至2019年12月北部战区总医院收治的98例Garden Ⅲ型中青年股骨颈骨折患者为研究对象。根据内固定方式不同将患者分为空心钉组(n=46)与DHS组(n=52)。所有患者均获得≥9个月的随访,比较两组患者围术期指标、术后愈合情况及功能评分等。结果 空心钉组患者手术时间、住院时间明显短于DHS组,透视时间明显长于DHS组,术中出血量明显少于DHS组,差异均有统计学意义(P <0.05)。空心钉组患者股骨颈短缩差异高于DHS组,差异有统计学意义(P <0.05)。两组患者的骨折愈合时间、Harris髋关节功能评分比较,差异无统计学意义(P> 0.05)。结论 倒“品”字形空心钉与DHS结合空心钉两种内固定方式均具有良好的临床疗效。倒“品”字形空心钉内固定方式具有术中出血量少、手术时间短等优点;DHS结合空心钉固定方式可更好地维持复位效果,且术中透视较少。Objective To compare the efficacy of inverted“pin”shaped cannulated screws and dynamic hip screw(DHS)combined with cannulated screw internal fixation in the treatment of Garden typeⅢfemoral neck fracture in middle-aged and young patients.Methods Ninety-eight middle-aged and young patients with femoral neck fracture of Garden typeⅢadmitted from January 2015 to December 2019 were selected as the study objects.Patients were divided into cannulated screw group(n=46)and DHS group(n=52)according to different internal fixation methods.All patients were followed up for at least 9 months to evaluate the results within perioperative indexes,postoperative healing and functional scores.Results The operation time of cannulated screw group was significantly lower than that of DHS group,while the duration of fluoroscopy time was significantly higher than that of DHS group,and the differences were statistically significant(P<0.05).The intraoperative blood loss and hospital stay in cannulated screw group were lower than those in DHS group,and the differences were statistically significant(P<0.05).The femoral neck shortness post-operation in cannulated screw group was higher than that in DHS group,and the difference was statistically significant(P<0.05).But there was no significant difference in fracture healing time and Harris hip score between the two groups(P>0.05).Conclusion Both internal fixation methods exerted optimal clinical effects.Internal fixation with inverted“pin”shaped cannulated screws has the advantages of less intraoperative bleeding and short operation time.DHS combined with cannulated screw fixation has better reduction effect and less intraoperative fluoroscopy.

关 键 词：股骨颈骨折 GardenⅢ型 空心钉 动力髋关节螺钉 内固定 

分 类 号：R687.3[医药卫生—骨科学]