股骨近端锁定接骨板与闭合复位半螺纹空心螺钉固定治疗PauwelsⅢ型股骨颈骨折疗效比较  

Comparison of the effects of proximal femoral locking compression plate and cannulated screws in the treatment of PauwelsⅢfemoral neck fracture

作　　者：刘建鹏[1] 田鹏[1] 李雪峰[1] 范嘉文 侯小冬[1] 白松林 范红旗[1] LIU Jian-peng;TIAN Peng;LI Xue-feng;FAN Jia-wen;HOU Xiao-dong;BAI Song-lin;FAN Hong-qi(Department of Orthopaedics,CPLA Ground Force 82nd Army Hospital,Baoding,Hebei,071000,China)

机构地区：[1]中国人民解放军陆军第八十二军集团军医院骨科,保定071000

出　　处：《中国骨与关节杂志》2024年第6期444-448,共5页Chinese Journal of Bone and Joint

摘　　要：目的探讨股骨近端锁定接骨板(proximal femoral locking compression plate,PFLCP)与半螺纹空心钉治疗中青年PauwelsⅢ型股骨颈骨折的疗效。方法选取2011年1月至2021年12月,我科收治的PauwelsⅢ型股骨颈骨折患者62例,其中男42例,女20例。按随机数字表法分为A、B两组,A组为3枚半螺纹空心螺钉固定(n=31),其中男20例、女11例;B组为PFLCP固定(n=31),男22例,女9例。术后进行12个月随访,观察记录股骨颈骨折内固定术后愈后情况。对比A、B组患者手术操作时间、骨折不愈合发生率,分析骨折复位质量并测量患侧股骨颈短缩等数据;进行髋关节Harris评分。结果两组手术时间和股骨头坏死率差异无统计学意义(P>0.05)。螺钉松动共10例,A组9例,B组1例,差异有统计学意义(P=0.010);股骨颈短缩共9例,A组8例,B组1例,差异有统计学意义(P=0.012);股骨颈骨折不愈合共11例,A组9例,B组2例,差异有统计学意义(P=0.018);术后12个月Harris评分,A组平均(60.37±4.82)分,B组平均(75.57±9.13)分,差异有统计学意义(P=0.031)。结论相比于使用3枚半螺纹空心螺钉,使用PFLCP可显著提高骨折改善治疗效果,可为PauwelsⅢ型股骨颈骨折治疗提供新的选择。Objective To investigate the curative effect of proximal femoral locking compression plate and cannulated screws in the treatment of PauwelsⅢfemoral neck fracture in young and middle-aged adults.Methods From January 2011 to December 2021,62 patients with PauwelsⅢfemoral neck fracture were enrolled,including 42 males and 20 females.All were divided into 2 groups according to the random number list method.Group A(general group):fracture fixation by three half-thread cannulated screws;n=31;20 males and 11 females.Group B(control group):fracture fixation by proximal femoral locking compression plate;n=31;22 males and 9 females.All patients were followed up for 12 months to observe the prognosis.The operation time and fracture nonunion rate were compared in both groups.The reduction quality of the fracture was analyzed and the femoral neck shortening of the affected side was measured.Harris score of the hip joint was assessed.Results There was no significant difference in operation time between the two groups(P>0.05).There was no significant difference in femoral head necrosis rate between the two groups(P>0.05).There were 10 cases of screw loosening,9 cases in Group A and 1 case in Group B with statistically significant difference(P=0.010).There were 9 cases of femoral neck shortening,8 cases in Group A and 1 case in Group B with statistically significant difference(P=0.012).There were 11 cases of femoral neck fracture nonunion,9 cases in Group A and 2 cases in Group B with statistically significant difference(P=0.018).Effects were evaluated in both Group A and B 12 months after the operation,and the average Harris hip scores were(60.37±4.82)and(75.57±9.13)with statistically significant difference(P=0.031).Conclusions Compared with fracture fixation by three half-thread cannulated screws,fracture fixation by proximal femoral locking compression plate can improve the treatment effects,providing new options for the treatment of PauwelsⅢfemoral neck fracture.

关 键 词：股骨颈骨折 骨折固定术 内 骨螺丝 骨板 

分 类 号：R683.4[医药卫生—骨科学]