两种内固定治疗青壮年PauwelsⅢ型股骨颈骨折的疗效比较  

Comparison efficacy of two internal fixation in the treatment of femoral neck fractures of Pauwels type-Ⅲin young adults

作　　者：丁惠宇 李永祥[1] 金杰 钱冬晨[1] 严一峰 王琼[1] DING Hui-yu;LI Yong-xiang;JIN Jie;QIAN Dong-chen;YAN Yi-feng;WANG Qiong(Dept of Orthopaedics and Traumatology,the Second Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210017,China)

机构地区：[1]南京中医药大学第二附属医院骨伤科,江苏南京210017

出　　处：《临床骨科杂志》2025年第1期90-94,共5页Journal of Clinical Orthopaedics

摘　　要：目的比较股骨颈动力交叉钉系统(FNS)和空心拉力螺钉(CCS)两种内固定治疗青壮年PauwelsⅢ型股骨颈骨折的疗效。方法将19例青壮年PauwelsⅢ型股骨颈骨折患者按内固定方法不同分为观察组(采用FNS内固定治疗,11例)和对照组(采用CCS内固定治疗,8例)。记录两组手术情况、骨折愈合情况、完全负重时间、患侧股骨近端短缩发生率以及并发症发生情况,采用Harris评分评价髋关节功能恢复情况。结果患者均获得6个月随访。手术时间两组比较差异无统计学意义(P>0.05),术中出血量CCS组少于FNS组(P<0.05),术中透视次数CCS组多于FNS组(P<0.05)。完全负重时间、骨折愈合时间、术后6个月Harris评分两组比较差异均无统计学意义(P>0.05)。术后6个月患侧股骨近端短缩发生率CCS组高于FNS组(P<0.05)。并发症发生率两组比较差异无统计学意义(P>0.05)。结论FNS和CCS内固定治疗青壮年PauwelsⅢ型股骨颈骨折在患者功能恢复情况上差异不明显,FNS内固定术中透视次数少,但术中出血量较多。Objective To compare the efficacy of femoral neck dynamic cross screw system(FNS)and cannulated cancellous screw(CCS)in the treatment of Pauwels type-Ⅲfemoral neck fracture in young adults.Methods The 19 young patients with Pauwels type-Ⅲfemoral neck fractures were divided into observation group(FNS internal fixation treatment,11 cases)and control group(CCS internal fixation treatment,8 cases),according to different internal fixation methods.Operation status,fracture healing,full weight-bearing time,incidence of proximal femur shortening of effected side and complications incidence situation were recorded in the two groups.The Harris score was used to evaluate the functional recovery of hip joint.Results All patients were followed up for 6 months.There was no statistical difference in operation time between the two groups(P>0.05).The intraoperative blood loss volume in CCS group was less than that in FNS group(P<0.05),and the frequency of intraoperative fluoroscopy in CCS group was more than that in FNS group(P<0.05).There were no statistical differences in full weight-bearing time,fracture healing time and Harris score 6 months after surgery between the two groups(P>0.05).The incidence of proximal femur shortening at 6 months after operation was higher in CCS group than in FNS group(P<0.05).There was no statistical difference in complication incidence between the two groups(P>0.05).Conclusions In the treatment of Pauwels type-Ⅲfemoral neck fracture in young adults,there is no obvious difference in functional recovery between FNS and CCS.FNS internal fixation has fewer fluoroscopy times,but more intraoperative blood loss.

关 键 词：股骨颈动力交叉钉系统 空心拉力螺钉 股骨颈骨折 

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