两种内固定术式治疗高龄无移位型股骨颈骨折的疗效  

Effect of two kinds of internal fixation surgical methods on non-displaced femoral neck fractures in senile patients

作　　者：陆奇峰[1] 唐根林[1] 李庆嵩[1] 姜秋平 LU Qi-feng;TANG Gen-lin;LI Qing-song;JIANG Qiu-ping(Dept of Traumatic Orthopaedics,the People′s Hospital of Taizhou City,Taizhou,Jiangsu 225300,China)

机构地区：[1]泰州市人民医院创伤骨科,江苏泰州225300

出　　处：《临床骨科杂志》2024年第3期395-399,共5页Journal of Clinical Orthopaedics

摘　　要：目的比较股骨近端锁定接骨板与空心螺钉内固定治疗高龄无移位型股骨颈骨折的疗效。方法根据内固定不同将66例高龄无移位型股骨颈骨折患者分为接骨板组(32例,采用股骨近端锁定接骨板内固定治疗)和螺钉组(34例,采用空心螺钉内固定治疗)。记录两组手术情况、骨折愈合时间、髋关节Harris评分、术后并发症发生情况。结果患者均获得随访,时间6~95个月。手术时间、切口长度、术中出血量、术后血红蛋白下降量两组比较差异均无统计学意义(P>0.05),下床部分负重锻炼时间接骨板组早于螺钉组(P<0.05)。接骨板组骨折均顺利愈合,时间3.5~8.0(4.63±1.04)个月;螺钉组中出现1例骨折不愈合,其余33例骨折愈合时间为3.0~7.5(5.03±1.04)个月;骨折愈合时间两组比较差异无统计学意义(P>0.05)。术后6个月髋关节Harris评分两组比较差异无统计学意义(P>0.05);但髋关节Harris评分优良率接骨板组高于螺钉组(P<0.05)。术后早期并发症发生率两组比较差异无统计学意义(P>0.05),中远期并发症发生率螺钉组高于接骨板组(P<0.05)。结论股骨近端锁定接骨板与空心螺钉内固定治疗高龄无移位型股骨颈骨折均可获得满意疗效,与空心螺钉相比,股骨近端锁定接骨板治疗早期髋关节功能恢复更好,中远期并发症更少。Objective To compare the efficacy of proximal femoral locking plate and cannulated screw internal fixation for treatment of non-displaced femoral neck fractures in the senile patients.Methods According to different internal fixation,66 senile patients with non-displaced femoral neck fractures were divided into bone plate group(32 cases,proximal femoral locking plate treatment)and screw group(34 cases,cannulated screw treatment).Operation conditions,fracture healing time,hip Harris score and postoperative complications were recorded in the two groups.Results Both groups were followed up for 6~95 months.There were no statistical differences in operation time,incision length,intraoperative blood loss and postoperative hemoglobin decline between the two groups(P>0.05).The time of partial weight-bearing in the bone plate group was earlier than the screw group(P<0.05).In the bone plate group,all fractures healed smoothly,and the time was 3.5~8.0(4.63±1.04)months;in the screw group,nonunion occurred in 1 case,and the other 33 cases healed within 3.0~7.5(5.03±1.04)months;there was no statistical difference in fracture healing time between the two groups(P>0.05).Six months after surgery,there was no statistical difference in hip Harris score between the two groups(P>0.05),while the excellent-good rate of hip joint Harris score in the bone plate group was higher than that in the screw group(P<0.05).There was no statistical difference in the incidence rate of postoperative early complications between the two groups(P>0.05),and the incidence rate of medium-long term complications in screw group was higher than that in bone plate group(P<0.05).Conclusions Both proximal femoral locking plate and cannulated screw internal fixation can obtain satisfactory efficacy in the treatment of senile patients with non-displaced femoral neck fractures,compared with cannulated screw,proximal femoral locking plate has better early hip function recovery,and fewer medium-long term complications.

关 键 词：股骨颈骨折 高龄 股骨近端锁定接骨板 空心螺钉内固定 

分 类 号：R683.42[医药卫生—骨科学] R687.32[医药卫生—外科学]