摘要
目的 ：比较两种直径空心钉治疗股骨颈骨折的临床疗效差异。方法 ：2008年6月至2013年6月,采用闭合复位空心钉内固定治疗117例青壮年股骨颈骨折患者,分别使用6.5 mm空心钉和8.0 mm空心钉,其中6.5 mm组48例,年龄19~60岁,平均（45.61±11.99）岁,男30例,女18例,GardenⅠ/Ⅱ型17例,GardenⅢ/Ⅳ型31例;8.0 mm组69例,年龄18~60岁,平均（45.17±9.95）岁,男40例,女29例,GardenⅠ/Ⅱ型31例,GardenⅢ/Ⅳ型38例。记录并比较分析两组病例的一般资料、手术时间、住院时间、复位质量、股骨颈头颈部直径、骨折愈合时间、骨折愈合率、术后并发症情况,术后髋关节功能评分采用Harris评分。结果：两组患者均获随访,时间18~24个月,平均19.6个月。两组病例的手术时间、住院时间、复位质量差异均无统计学意义（P〉0.05）。两组病例的股骨颈头颈部平均直径、骨折愈合时间、骨折愈合率、术后并发症差异均无统计学意义（P〉0.05）。两组病例术后髋关节功能Harris评分均较好,疗效显著。GardenⅢ/Ⅳ型股骨头坏死发生率高于GardenⅠ/Ⅱ型,差异有统计学意义。结论 ：对于青壮年的股骨颈骨折,闭合复位空心钉内固定治疗是首选的手术方法,两种不同直径空心钉闭合复位内固定治疗股骨颈骨折时不会影响骨折愈合的时间及术后并发症的发生。
Objective：To evaluate and compare the outcome of two kinds of diameter hollow screws for the treatment of femoral neck fractures. Methods：From June 2008 to June 2013,117 patients with femoral neck fractures were treated by closed reduction and hollow screws fixation. Among them,48 patients were fixed by 6.5 mm screw including 30 males and 18 females with an average age of（45.61±11.99） years old ranging from 19 to 60 years old,involving 17 cases in GardenⅠ / Ⅱand 31 cases in Garden Ⅲ / Ⅳ;69 patients were fixed by 8.0 mm screw including 40 males and 29 females with an average age of（45.17±9.95） years old ranging from 18 to 60 years old,involving 31 cases in GardenⅠ / Ⅱ and 38 cases in Garden Ⅲ / Ⅳ.The general information,operative time,hospital stay time,reduction quality,diameter of femoral head and neck,fracture healing time,the rate of fracture healing,postoperative complications were recorded and evaluated. Harris scoring was used to evaluate the hip joint function. Results：All patients were followed up for 19.6 months（18 to 24 months）. The difference of operative time,duration of hospitalization,quality of reduction were not statistically significant（P〉0.05）. There was no difference between two groups about the average diameter of the femoral head and neck,the fracture healing time,the rate of healing and the postoperative complications（P〉0.05）. There were no difference between two groups about Harris scale. There were significant difference between Garden Ⅲ / Ⅳ andⅠ / Ⅱ（P〉0.05）. Conclusion：Closed reduction and internal fixation with hollow screw in treating the young adult patients with femoral neck fracture is the first choice,both different diameters hollow screws could meet the requirements of fixation of femoral neck fracture,and not affect on fracture healing time and postoperative complications.
出处
《中国骨伤》
CAS
2015年第9期792-795,共4页
China Journal of Orthopaedics and Traumatology
基金
温州市科技局科研基金资助项目(编号:Y20130183)~~
关键词
股骨颈骨折
骨折固定术
内
外科手术
Femoral neck fractures
Fracture fixation
internal
Surgical procedures
operative
