股骨颈内固定系统与关节置换术治疗PauwelsⅢ型股骨颈骨折效果比较  

Efficacy of femoral neck internal fixation system versus arthroplasty in treatment of Pauwels typeⅢfemoral neck fracture

作　　者：曲强 崔鹏飞 文章坤 王昌耀[2] QU Qiang;CUI Pengfei;WEN Zhangkun;WANG Changyao(Faculty of Medicine,Qingdao University,Qingdao 266071,China)

机构地区：[1]青岛大学医学部,山东青岛266071 [2]青岛大学附属医院关节外科

出　　处：《精准医学杂志》2024年第5期400-403,共4页Journal of Precision Medicine

基　　金：国家自然科学基金项目(81772329)。

摘　　要：目的对股骨颈内固定系统(FNS)与关节置换术治疗PauwelsⅢ型股骨颈骨折的效果进行比较。方法回顾性分析我院2019年1月-2021年1月期间手术治疗的96例PauwelsⅢ型股骨颈骨折患者的资料。根据手术方式将患者分为FNS组39例和关节置换组57例,比较两组患者的基本资料、入院及手术相关资料、术后12月时髋关节Harris评分等。结果与FNS组比较,关节置换组患者的手术时间显著延长,术中出血量显著增加(t=9.27,t′=92.81,P<0.05),但住院时间显著缩短,术后可负重时间显著提前(t=14.61、23.21,P<0.05)。两组患者随访12月时Harris评分差异无显著性(P>0.05)。随访至术后12个月时,FNS组和关节置换组患者中分别有5、6例发生术后并发症,两组比较无明显差异(P>0.05)。结论关节置换术能够缩短PauwelsⅢ型股骨颈骨折患者住院时间,实现患者早期负重和功能锻炼,减少患者卧床时间,临床上应根据患者具体情况选择合适的人工假体进行关节置换手术,以使患者更大获益。Objective To investigate the efficacy of femoral neck system(FNS)for internal fixation versus arthroplasty in the treatment of Pauwels typeⅢfemoral neck fracture.Methods A retrospective analysis was performed for the data of 96 patients with Pauwels typeⅢfemoral neck fracture who received surgical treatment in our hospital from January 2019 to January 2021,and according to the surgical procedure,they were divided into FNS group with 39 patients and arthroplasty group with 57 patients.The two groups were compared in terms of general information,admission and surgery data,and Harris score of the hip joint at 12 months after surgery.Results Compared with the FNS group,the arthroplasty group had a significantly longer time of operation and a significantly greater intraoperative blood loss(t=9.27,t′=92.81,P<0.05),as well as significantly shorter length of hospital stay and postoperative weight-bearing time(t=14.61,23.21,P<0.05).There was no significant difference in Harris score at 12 months of follow-up between the two groups(P>0.05).At 12 months of follow-up,5 patients in the FNS group and 6 in the arthroplasty group experienced postoperative complications,and there was no significant difference between the two groups(P>0.05).Conclusion For patients with Pauwels typeⅢfemoral neck fracture,arthroplasty can shorten the length of hospital stay,achieve early weight-bearing and functional exercise,and reduce the time of lying in bed.An appropriate artificial prosthesis should be selected for arthroplasty according to the specific condition of the patient,so as to bring more benefits to the patient.

关 键 词：股骨颈骨折 关节成形术 置换 髋 骨折固定术 内 PauwelsⅢ型 治疗结果 

分 类 号：R683.42[医药卫生—骨科学] R687.42[医药卫生—外科学] R687.3[医药卫生—临床医学]