经皮空心钉联合改良滑动加压动力髋螺钉内固定治疗股骨颈骨折  

Percutaneous cannulated screw combined with improved sliding compression dynamic hip screw internal fixation for treatment of femoral neck fractures

作　　者：宋永清 宋儒龙 欧意权 陈泽港 SONG Yong-qing;SONG Ru-long;OU Yi-quan;CHEN Ze-gang(Dept of Orthopaedics,Song Zunxiu Memorial Hospital,Chenzhou,Hunan 424100,China)

机构地区：[1]宋尊秀纪念医院骨科,湖南郴州424100

出　　处：《临床骨科杂志》2024年第4期543-547,共5页Journal of Clinical Orthopaedics

摘　　要：目的探讨经皮空心钉联合改良滑动加压动力髋螺钉内固定治疗股骨颈骨折的疗效。方法将35例股骨颈骨折患者按内固定方式不同分为传统组(采用经皮空心钉内固定治疗,22例)和改良组(采用经皮空心钉联合改良滑动加压动力髋螺钉内固定治疗,13例)。比较两组手术时间、术后下地时间、住院时间、骨折愈合时间、并发症发生情况。采用Harris评分评价髋关节功能。结果患者均获得随访,时间6~36(19.57±9.45)个月。手术时间、住院时间两组比较差异均无统计学意义(P>0.05);术后下地时间、骨折愈合时间改良组均短于传统组(P<0.05)。两组均无骨折不愈合及股骨头坏死情况发生;股骨颈短缩率改良组低于传统组(P<0.05)。末次随访时Harris评分优良率改良组高于传统组(P<0.05)。结论改良滑动加压动力髋螺钉符合股骨颈解剖和生物力学特点,与经皮空心钉联合内固定治疗股骨颈骨折,具有患者术后下地时间早、骨折愈合时间短、股骨颈短缩率低、髋关节功能恢复好的优势。Objective To investigate the efficacy of percutaneous cannulated screw combined with improved sliding compression dynamic hip screw internal fixation for treatment of femoral neck fractures.Methods The 35 patients with femoral neck fractures were divided into the conventional group(The 22 cases were treated with percutaneous cannulated screw internal fixation)and the improved group(The 13 cases were treated with percutaneous cannulated screw combined with improved sliding compression dynamic hip screw internal fixation)based on different internal fixation methods.The following data were compared between two groups,including the surgical time,postoperative loading on ground time,hospitalization time,fracture healing time and occurrence of complications between the two groups.Hip joint function was evaluated with using Harris score.Results All patients were followed up for 6~36(19.57±9.45)months.There were no statistical differences between the two groups in surgical time and hospitalization time(P>0.05);the postoperative loading on ground time and fracture healing time in the improved group were shorter than those in the conventional group(P<0.05).There were no cases of nonunion or femoral head necrosis in both groups;the femoral neck shortening rate in the improved group was lower than that in the conventional group(P<0.05).At the last follow-up,the excellent-good rate of Harris score in the improved group was higher than the conventional group(P<0.05).Conclusions The improved sliding compression dynamic hip screw is in line with the anatomical and biomechanical characteristics of the femoral neck,which combined with percutaneous cannulated screws internal fixation for treatment of femoral neck fractures have the advantages of early posteroperaive time of loading on the ground,short fracture healing time,low femoral neck shortening rate,and good hip joint function recovery for patients.

关 键 词：股骨颈骨折 经皮空心螺钉 改良 滑动加压 动力髋螺钉 

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