股骨颈动力交叉钉系统与空心加压螺钉内固定治疗中青年股骨颈骨折的meta分析  

Meta-analysis of femoral neck system and cannulated compression screw internal fixation in the treatment of femoral neck fractures in young and middle-aged patients

作　　者：李昊轩 刘成日 金光文 张欢 顾明原 金日 Li Haoxuan;Liu Chengri;Jin Guangwen;Zhang Huan;Gu Mingyuan;Jin Ri(Department of Orthopaedics,Yanbian University Hospital,Yanji 133000,China)

机构地区：[1]延边大学附属医院(延边医院)骨科,延吉133000

出　　处：《中华骨科杂志》2025年第5期294-301,共8页Chinese Journal of Orthopaedics

摘　　要：目的比较股骨颈动力交叉钉系统(femoral neck system,FNS)与空心加压螺钉内固定治疗中青年股骨颈骨折的临床疗效。方法检索中国知网、万方数据知识服务平台、维普、中华医学期刊全文数据库、PubMed、Embase、Web of Science、Cochrane library数据库。提取术中出血量、术中透视次数、住院时间、骨折愈合时间、Harris髋关节功能评分、部分负重时间及并发症发生率等指标,比较两种手术方式的临床疗效。采用Stata18.0统计学软件进行meta分析。结果共11项研究的699例患者纳入本研究。与空心加压螺钉内固定相比,FNS的手术时间[WMD=-8.54,95%CI(-14.87,-2.21),P=0.008]、术中透视次数[WMD=-8.29,95%CI(-11.45,-5.12),P<0.001]、骨折愈合时间[WMD=-1.59,95%CI(-2.49,-0.68),P=0.001]、部分负重时间[WMD=-3.45,95%CI(-4.43,-2.46),P<0.001]、术后并发症发生率[RR=0.41,95%CI(0.22,0.76),P=0.004],术后骨不连发生率[RR=0.40,95%CI(0.18,0.88),P=0.022]小于空心加压螺钉内固定,术中出血量[WMD=9.53,95%CI(2.70,16.35),P=0.006]、末次随访的Harris髋关节功能评分[WMD=3.50,95%CI(2.11,4.89),P<0.001]大于空心加压螺钉内固定。两组住院时间[WMD=-0.48,95%CI(-0.82,-0.13),P=0.092]和股骨头坏死率[RR=0.57,95%CI(0.26,1.24),P=0.159]的差异无统计学意义。结论与空心加压螺钉内固定相比,FNS治疗中青年股骨颈骨折术中出血量更多,但在手术时间、术中出血量、术中透视次数、术后骨折愈合时间、Harris髋关节功能评分、部分负重时间、术后骨不连发生率、术后并发症发生率方面更具优势。ObjectiveTo compare the clinical effect of femoral neck system(FNS)and cannulated compression screw internal fixation in the treatment of femoral neck fractures in young and middle-aged patients.MethodsThe databases of CNKI,Wanfang Data Knowledge Service Platform,VIP,Chinese Medical Journal Full-text Database,PubMed,Embase,Web of Science and Cochrane Library were searched.The intraoperative blood loss,intraoperative fluoroscopy times,hospital stay,fracture healing time,Harris hip function score,partial weight-bearing time and complication rate were extracted to compare the clinical efficacy of the two surgical methods.Stata18.0 statistical software was used for meta-analysis.ResultsA total of 699 patients from 11 studies were included in this study.Compared with cannulated compression screw internal fixation,the FNS had a shorter operation time[WMD=-8.54,95%CI(-14.87,-2.21),P=0.008],fewer intraoperative fluoroscopy times[WMD=-8.29,95%CI(-11.45,-5.12),P<0.001],a shorter fracture healing time[WMD=-1.59,95%CI(-2.49,-0.68),P=0.001],a shorter partial weight-bearing time[WMD=-3.45,95%CI(-4.43,-2.46),P<0.001],a lower incidence of postoperative complications[RR=0.41,95%CI(0.22,0.76),P=0.004],and a lower incidence of postoperative nonunion[RR=0.40,95%CI(0.18,0.88),P=0.022].Meanwhile,the FNS group had more intraoperative blood loss[WMD=9.53,95%CI(2.70,16.35),P=0.006]and a higher Harris hip function score at the last follow-up[WMD=3.50,95%CI(2.11,4.89),P<0.001]than the cannulated compression screw internal fixation group.There were no statistically significant differences in the length of hospital stay[WMD=-0.48,95%CI(-0.82,-0.13),P=0.092]or the incidence of femoral head necrosis[RR=0.57,95%CI(0.26,1.24),P=0.159]between the two groups.ConclusionCompared with cannulated compression screw internal fixation in the treatment of femoral neck fracture in young and middle-aged patients,FNS has more intraoperative blood loss,but it has more advantages in operation time,intraoperative blood loss,intraoperative fluoroscopy times,post

关 键 词：股骨颈骨折 骨折固定术 内 META分析 

分 类 号：R687.3[医药卫生—骨科学]