股骨颈动力交叉钉系统与空心钉内固定治疗移位股骨颈骨折的疗效比较  

Comparison of efficacy between femoral neck system and cannulated screw internal fixation in treatment of displaced femoral neck fractures

作　　者：胡林杰 李博康 杨永庆 陈国仙 HU Linjie;LI Bokang;YANG Yongqing;CHEN Guoxian(Department of Orthopaedics,Putian First Hospital,Putian,Fujian 351100,China)

机构地区：[1]莆田市第一医院骨科,福建351100

出　　处：《中国骨与关节损伤杂志》2025年第2期123-127,共5页Chinese Journal of Bone and Joint Injury

基　　金：莆田学院课题(莆院科[2023]010号2023093)。

摘　　要：目的比较股骨颈动力交叉钉系统(Femoral neck system,FNS)与空心钉内固定治疗移位股骨颈骨折的临床疗效。方法回顾性分析自2020-10—2022-10手术治疗的56例移位股骨颈骨折,其中18例采用FNS内固定治疗(FNS组),38例采用3枚空心钉倒三角形内固定治疗(空心钉组)。比较两组手术时间、术中X线透视次数、术后血红蛋白下降值、术后24 h疼痛VAS评分、骨折复位质量、骨折愈合时间、术后6个月髋关节功能Harris评分、并发症情况。结果56例均获得随访,随访时间9~28个月,平均13个月。FNS组和空心钉组在手术时间、术后血红蛋白降低值、术后24 h疼痛VAS评分、骨折复位质量、骨折愈合时间、术后6个月髋关节功能Harris评分、术后早期并发症发生率方面差异无统计学意义(P>0.05)。FNS组术中X线透视次数明显少于空心钉组,差异有统计学意义(P<0.05)。FNS组大腿外侧激惹发生率低于空心钉组,差异有统计学意义(P<0.05);两组股骨颈缩短、股骨头缺血性坏死、骨折不愈合、内固定失效发生率差异无统计学意义(P>0.05)。结论FNS与空心钉内固定治疗移位股骨颈骨折均可取得较满意的早期临床疗效,FNS内固定手术微创且操作简便,可以明显减少术中X线透视次数,有效预防内固定物突出造成大腿外侧激惹症状。ObjectiveTo compare the clinical efficacy of femoral neck system(FNS)and cannulated screw internal fixation in the treatment of displaced femoral neck fractures.MethodsA retrospective analysis was conducted on 56 cases of displaced femoral neck fractures treated with surgery from October 2020 to October 2022.Among them,18 cases were treated with FNS internal fixation(FNS group),and 38 cases were treated with three cannulated screws in an inverted triangle configuration(CCS group).The operation time,intraoperative X-ray fluoroscopy times,the decrease in postoperative hemoglobin,the VAS score at24 hours after surgery,the quality of fracture reduction,the fracture healing time,the Harris score of hip joint function at 6months after surgery,and the complications were compared between the two groups.ResultsAll 56 cases were followed up for9 to 28 months,with an average follow-up duration of 13 months.No statistically significant differences were observed between the FNS group and the CCS group in terms of operative time,postoperative hemoglobin reduction,pain VAS score at 24 hours post-surgery,quality of fracture reduction,fracture healing time,Harris hip function score at six months after surgery,and incidence of early postoperative complications(P>0.05).The number of intraoperative X-ray fluoroscopies in the FNS group was significantly lower compared to the cannulated screw group,with this difference being statistically significant(P<0.05).Additionally,the incidence of lateral thigh irritation in the FNS group was lower than that in the cannulated screw group,with this difference also being statistically significant(P<0.05).There were no significant differences between the two groups regarding the incidence of femoral neck shortening,avascular necrosis of the femoral head,fracture nonunion,and internal fixation failure(P>0.05).ConclusionBoth FNS and cannulated screw internal fixation can achieve satisfactory early clinical efficacy in the treatment of displaced femoral neck fractures.FNS internal fixation is minimal

关 键 词：移位股骨颈骨折 股骨颈动力交叉钉系统 空心钉 内固定 

分 类 号：R687.3[医药卫生—骨科学]