不同螺钉构型内固定对老年GardenⅢ型股骨颈骨折的影响  

Effect of different screw configurations on elderly GardenⅢfemoral neck fracture

作　　者：何晓艳 张立[1] 张颖[1] 王立平 王婧琦 HE Xiaoyan;ZHANG Li;ZHANG Ying;WANG Liping;WANG Jingqi(Department of Orthopaedics,Tangshan Second Hospital,Tangshan 063000,China)

机构地区：[1]唐山市第二医院骨科,063000

出　　处：《国际骨科学杂志》2024年第5期340-343,共4页International Journal of Orthopaedics

基　　金：河北省2020年度医学科学研究课题计划(20201450)。

摘　　要：目的分析不同螺钉构型内固定对老年GardenⅢ型股骨颈骨折的影响。方法选取唐山第二医院骨科2023年2月至2023年12月收治的60例老年GardenⅢ型股骨颈骨折患者。根据治疗方法分为2组,对照组33例患者采取常规3枚空心钉倒三角构型内固定治疗,观察组27例患者采用4枚空心钉菱形四壁支撑构型内固定治疗。术后比较两组患者术中出血量、手术时间、骨折延迟愈合率、髋关节功能恢复情况及髋臼外展角等。结果对照组患者骨折延迟愈合率明显高于观察组,对照组患者Harris髋关节功能评分及改良Barthel评分明显低于观察组,差异有统计学意义(P<0.05)。观察组髋臼外展角优于对照组(P<0.05)。两组术中出血量及手术时间无明显差异(P>0.05)。结论相较于3枚空心钉倒三角构型内固定,4枚空心钉菱形构型内固定治疗老年GardenⅢ型股骨颈骨折患者具有一定的优势,特别是在改善术后髋关节功能和促进骨折愈合方面。Objective To analyze the effect of different screw configurations on senile GardenⅢfemoral neck fracture.Methods Sixty elderly patients with type GardenⅢfemoral neck fracture admitted to the orthopedic department of Tangshan Second Hospital from February 2023 to December 2023 were selected.According to their treatment method,these patients were divided into two groups.The control group of 33 patients was treated with the three hollow-nail inverted-triangle configuration,and 27 patients in the observation group were treated with the four hollow-nail diamond four-wall support configuration.After surgery,the intraoperative blood loss,operation time,delayed fracture healing rate,hip function recovery,and acetabular abduction angle were compared between the two groups.Results The rate of delayed fracture healing in the control group was significantly higher than that in the observed group,and the Harris hip function score and modified Barthel score were significantly lower than those in the observed group(P<0.05).The acetabular abduction angle in the observation group was better than that in the control group(P<0.05).There was no significant difference in intraoperative bleeding volume and operation time between the two groups(P>0.05).Conclusion Compared to three inverted triangular fixation,four hollow-nail diamond fixation has certain advantages in treating elderly patients with GardenⅢfemoral neck fracture,especially in improving postoperative hip function and promoting fracture healing.

关 键 词：螺钉构型 老年股骨颈骨折 髋关节功能 

分 类 号：R687.3[医药卫生—骨科学]