股骨颈骨折康复时间、临床特点对伤残评定的影响  

Effect of Recovery Time and Clinical Characteristics on Forensic Disability Assessment of Femoral Neck Fracture

作　　者：陈焕 史舅生 CHEN Huan;SHI Jiusheng(Institute of Forensic Science,Changzhou Medical District,904 Hospital of the Joint Service Support Force of the Chinese People's Liberation Army,Changzhou 213000,China;Department of Orthopedics,Changzhou Medical District,904 Hospital of the Joint Service Support Force of the Chinese People’s Liberation Army,Changzhou 213000,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇四医院常州医疗区司法鉴定所,江苏常州213000 [2]中国人民解放军联勤保障部队第九〇四医院常州医疗区骨科二区,江苏常州213000

出　　处：《中国司法鉴定》2024年第2期61-66,共6页Chinese Journal of Forensic Sciences

基　　金：中国人民解放军联勤保障部队第九〇四医院2021年院级科研基金项目(MS202124)。

摘　　要：目的探讨交通事故致股骨颈骨折的康复时间、临床特点及其对伤残评定的影响。方法回顾性分析2020年至2022年在本院接受治疗的100例交通事故致股骨颈骨折患者的临床资料,根据治疗方式分为非手术治疗组(n=40)和手术治疗组(n=60),比较两组患者的康复时间、并发症发生率、骨折愈合情况、股骨头缺血坏死发生率、关节功能恢复情况及伤残评定结果。结果手术治疗组患者的康复时间[(6.8±1.5)个月]明显短于非手术治疗组[(9.2±2.1)个月,P<0.05],并发症发生率(15.0%)也明显低于非手术治疗组(32.5%,P<0.05)。两组患者的骨折愈合率无显著差异(P>0.05),但手术治疗组患者的股骨头缺血坏死发生率(30.0%)明显低于非手术治疗组(50.0%,P<0.05)。手术治疗组患者的关节功能恢复情况明显优于非手术治疗组,以Harris评分为例,手术治疗组患者的优良率为86.7%,而非手术治疗组为57.5%(P<0.05)。伤残评定结果显示,手术治疗组的伤残率明显低于非手术治疗组(P<0.05)。结论交通事故致股骨颈骨折患者的康复时间、临床特点及其对伤残评定的影响与治疗方式密切相关,手术治疗相比非手术治疗能够缩短康复时间,降低并发症发生率,改善关节功能恢复情况,降低伤残率。Objective The study examined the relationship between recovery time,clinical characteristics,and disability assessment results for patients with femoral neck fractures caused by traffic accidents.Methods A retrospective analysis was conducted on the clinical data of 100 cases treated in our institution from 2020 to 2022.Patients were categorized into non-operative treatment(n=40)and surgical treatment(n=60)groups.Comparative analysis covered information including recovery time,complication incidence,fracture healing status,femoral head ischemic necrosis rate,joint function recuperation,and disability assessment outcomes.Results Findings revealed that the surgical treatment group[(6.8±1.5)months]exhibited significantly shorter recovery time than the non-operative treatment group[(9.2±2.1)months,P<0.05],along with a lower complication incidence(P<0.05).Although no significant disparity in fracture healing rates was observed between the two groups(P>0.05),the surgical treatment group(30.0%)demonstrated a markedly lower femoral head ischemic necrosis rate compared to the non-operative treatment group(50.0%,P<0.05).Moreover,the surgical treatment group displayed superior joint function recovery,exemplified by a Harris score of 86.7%compared to 57.5%in the non-operative treatment group(P<0.05).Disability assessment outcomes indicated a significant reduction in disability occurrences within the surgical treatment group(P<0.05).Conclusion The impact of recovery time and clinical characteristics on disability assessment for femoral neck fractures due to traffic accidents is closely linked to treatment methods.Surgical intervention proves to be more effective than non-operative approaches in reducing recovery time,mitigating complication incidences,enhancing joint function recuperation,and reducing disability rates.

关 键 词：交通事故 股骨颈骨折 康复时间 临床特点 伤残评定 

分 类 号：DF795.4[医药卫生—法医学]