股骨颈系统与空心螺钉治疗中青年移位型股骨颈骨折的临床应用探讨  

Clinical application of femoral neck system and cannulated screws in the treatment of displaced femoral neck fractures in young and middle-aged patients

作　　者：杨嵩 雷哲 YANG Song;LEI Zhe(Zhengzhou Orthopedics Hospital Affiliated to Henan University,Zhengzhou 450052,China)

机构地区：[1]河南大学附属郑州市骨科医院,郑州450052

出　　处：《医药论坛杂志》2024年第4期408-412,共5页Journal of Medical Forum

摘　　要：目的探讨股骨颈系统(femoral neck system,FNS)与空心螺钉治疗中青年移位型股骨颈骨折的临床效果。方法选取郑州市骨科医院创伤骨科2021年1月至2022年1月期间收治的60例移位型股骨颈骨折,并且符合选择标准,随机将研究对象分为两组各30例(A组和B组)。其中女性23例,男性37例;年龄段从28岁~58岁,平均43岁。骨折类型按Garden分型:Ⅱ型12例,Ⅲ型28例,Ⅳ型20例。A组患者接受股骨颈系统(FNS)内固定术,B组采用空心螺钉内固定术。手术中记录操作时间,切口出血量及术中C臂透视次数,用Garden指数评价骨折复位质量,随访记录骨折愈合情况、时间,股骨颈短缩情况。比较两组的临床疗效及髋关节Harris评分。结果Garden指数评定:60例患者骨折复位均满意。其中A组手术中操作时间为(41.8±8.2)min;B组手术中操作时间(41.1±10.6)min,手术中操作时间比较差异无统计学意义(P>0.05)。A组出血量平均(76.0±12.6)mL,多于B组平均(35.5±12.6)mL;但术中C臂透视次数A组(16.4±3.4)少于B组(35.7±6.7),有统计学意义(P<0.05);两组患者住院天数及随访骨折愈合时间比较差异无统计学意义(P>0.05);两组患者末次复查X线显示股骨颈短缩3.0(1.5,3.3)vs.3.5(1.5,4.0)mm,差异无统计学意义(P>0.05)。末次随访均未发生股骨头坏死。A组髋关节Harris评分系统评定患髋功能:优19例,良8例,可3例,优良率90.0%。B组髋关节Harris评分系统评定患髋功能:优16例,良10例,可4例,优良率86.7%。两组患者髋关节功能恢复良好,评分比较差异无统计学意义(P>0.05)。结论股骨颈系统(FNS)和空心螺钉内固定手术优点相似,但股骨颈系统(FNS)能够有效减少住院时间、骨折愈合时间,术后髋关节功能恢复理想,可获得满意近期疗效。Objective To investigate the clinical effectiveness of femoral neck system(FNS)and cannulated screws in the treatment of displaced femoral neck fractures in young and middle-aged patients.Methods From January 2021 to January 2022,60 patients with displaced femoral neck fractures who met the selection criteria were selected and random-ly divided into two groups(group A and group B,with 30 cases in each group).There were 37 males and 23 females.The age ranged from 28 to 58 years(mean,43 years).The fracture types were classified according to Garden classifica-tion:12 cases of typeⅡ,28 cases of typeⅢ,and 20 cases of typeⅣ.Patients in group A were treated with femoral neck system(FNS)internal fixation,and patients in group B were treated with cannulated screw internal fixation.The operation time,the amount of bleeding from the incision,and intraoperative fluoroscopy times were recorded.The quali-ty of fracture reduction was evaluated by Garden index.The fracture healing,time,and femoral neck shortening were re-corded during follow-up.The clinical efficacy and Harris hip score were compared between the two groups.Results According to Garden index,all the 60 patients were satisfied with fracture reduction.The operation time of group A was(41.8±8.2)min;The operation time of group B was(41.1±10.6)min,there was no significant differ-ence in the comparison of intraoperative operation time(P>0.05).The intraoperative blood loss in group A was(76.0±12.6)mL,which was more than that in group B(35.5±12.6)mL.However,the number of intraoperative flu-oroscopy in group A(16.4±3.4)was less than that in group B(35.7±6.7),and the differences were statistically significant(P<0.05);There was no significant difference in the comparison of the number of days of hospitalization and the time of fracture healing at follow-up between the two groups(P>0.05);The femoral neck shortening was 3.0(1.5,3.3)vs.3.5(1.5,4.0)mm in the two groups,which was statistically meaningless(P>0.05).No femoral head necrosis occurred at the last follow-up

关 键 词：移位型股骨颈骨折 股骨颈系统(FNS) 空心螺钉 骨折内固定术 

分 类 号：R683[医药卫生—骨科学]