两种固定方式治疗股骨颈骨折的疗效比较  

Comparison of two fixation methods for treatment of femoral neck fractures

作　　者：杨冬松[1] 王琼[1] 凌建生 陈许冬 陈鹏[1] 远东涛[1] 甄相周[1] 吴广良[1] YANG Dong-song;WANG Qiong;LING Jian-sheng;CHEN Xu-dong;CHEN Peng;YUAN Dong-tao;ZHEN Xiang-zhou;WU Guang-liang(Dept of Orthopaedics,the Second Affiliated Hospital of Luohe Medical College,Luohe,Henan 462300,China)

机构地区：[1]漯河医学高等专科学校第二附属医院骨科,河南漯河462300

出　　处：《临床骨科杂志》2024年第6期834-838,共5页Journal of Clinical Orthopaedics

基　　金：河南省卫健委医学科技攻关项目(编号:LHGJ20200885);河南省科技厅重点研发与推广专项项目(编号:212102310722);河南省教育厅高等学校重点科研项目(编号:24B320011);漯河医学高等专科学校科技创新项目(编号:2022KJYB44)。

摘　　要：目的比较股骨颈交叉动力钉系统(FNS)与空心螺钉固定治疗股骨颈骨折的疗效。方法采用随机数字表法将46例股骨颈骨折患者分为FNS组(采用FNS固定治疗,23例)和空心螺钉组(采用空心螺钉固定治疗,23例)。比较两组手术情况、骨折愈合时间、髋关节Harris评分以及并发症发生情况。结果患者均获得随访,时间9~22个月。术中透视次数、手术时间FNS组少(短)于空心螺钉组(P<0.01),术中出血量、住院时间两组比较差异均无统计学意义(P>0.05)。骨折愈合时间FNS组短于空心螺钉组(P<0.05)。术后3个月内FNS组4例、空心螺钉组7例发生股骨颈短缩;术后均未发生感染、下肢深静脉血栓形成、内固定物失效、股骨头缺血性坏死等并发症。末次随访时,髋关节Harris评分两组比较差异无统计学意义(P>0.05)。结论FNS与空心螺钉固定治疗股骨颈骨折均能获得满意的治疗效果。与空心螺钉固定相比,FNS固定可明显减少透视次数,缩短手术及骨折愈合时间。Objective To compare the curative effect of femoral neck system(FNS)and cannulated screw fixation on femoral neck fracture.Methods The 46 patients with femoral neck fractures were divided into FNS group(23 cases)and cannulated screw group(23 cases)by random number table method.Operation situation,fracture healing time,hip Harris score and complications were compared between the two groups.Results All patients were followed up for 9~22 months.Intraoperative fluoroscopy frequency and operative time were less(shorter)in FNS group than those in cannulated screw group(P<0.01),and there were no statistical differences in intraoperative blood loss and hospitalization time between the two groups(P>0.05).The fracture healing time in FNS group was shorter than that in cannulated screw group(P<0.05).Within 3 months after operation,femoral shortening occurred in 4 patients of FNS group and 7 patients in cannulated screw group;and no complications such as infection,deep venous thrombosis of lower extremity,failure of internal fixation,or ischemic necrosis of femoral head occurred.At the last follow-up,there was no statistical difference in hip Harris score between the two groups(P>0.05).Conclusions Both FNS and cannulated screw can obtained satisfactory therapeutic effect in the treatment of femoral neck fracture;compared with cannulated screw fixation,FNS fixation can significantly reduce the frequency of fluoroscopy,and shorten the time of operation and fracture healing.

关 键 词：股骨颈骨折 骨折固定术 内 股骨颈动力交叉钉系统 空心螺钉 

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