摘要
目的:分析空心螺钉内固定术、锁定钢板内固定术治疗PauwelsⅢ型股骨颈骨折的选择优势及近期疗效。方法:选取接受手术治疗的PauwelsⅢ型股骨颈骨折患者60例,完全随机分为A组(n=30)和B组(n=30),A组行空心螺钉内固定术,B组行锁定钢板内固定术治疗。记录两组手术切口、住院时间等手术基本情况,比较两组术后并发症发生情况,并评估髋关节功能。结果:与B组相比,A组手术切口明显较小,手术时间显著较短,术中出血量显著较少(P<0.01),两组下床活动时间、住院时间比较差异无统计学意义(P>0.05)。A组股骨头坏死发生率20.00%明显高于B组3.33%(P<0.05),但A组螺钉松动、骨不愈合发生率6.67%、6.67%明显低于B组26.67%、30.00%(P<0.05);且A组Harris评分显著高于B组(P<0.05)。A组股骨头坏死、早期螺钉松动发生率15.00%、20.00%明显高于B组2.50%、5.00%,差异有统计学意义(P<0.05),A组感染、股骨颈短缩、骨不愈合发生率略低于B组,但差异无统计学意义(P>0.05),其中B组骨不愈合多发生于50-55岁患者,A组Harris评分显著高于B组(P<0.05)。结论:空心螺钉内固定术、锁定钢板内固定术均可用于治疗PauwelsⅢ型股骨颈骨折,但前者手术创伤、软组织损伤小,失血量少,且术后髋关节功能恢复效果更好,并发症发生率更低,安全性更高。
Objective：To analyze the advantages and short-term effects of internal fixation with cannulated screws and internal fixation with locking plate in the treatment of Panwels Ⅲ type femoral neck fractures. Methods：Sixty patients with Pauwels Ⅲ type femoral neck fractures treated by surgery were randomly divided into group A （n = 30） and group B （n = 30）. Group A underwent internal fixation with cannulated screws, and group B underwent internal fixation with locking plate.The basic conditions, such as incision and length of stay were recorded.The incidence of postoperative complications was compared between the two groups, and the hip joint function was evaluated. Results：Compared with group B, the incision in group A was significantly smaller, the duration of surgery was significantly shorter, and the intraoperative blood loss was significantly less （P〈0.01）. There were no significant differences in the time to ambulation and length of stay between the two groups （P〉 0.05） .The incidence of femoral head necrosis in group A was significantly higher than that in group B （ 20.00% vs 3.33%） （P〈0.05）, but the incidences of screw loosening and bone nonunion in group A were significantly lower than those in group B （6.67% vs 26.67%,6.67% vs 30.00%） ,respectively （P〈0.05）.The Harris score in group A was significantly higher than that of group B （P〈0.05）.The incidences of femoral head necrosis and early screw loosening in group A were significantly higher than those in group B （ 15.00% vs 2.50% ,20.00% vs 5.00%）, respectively （P〈0.05）.The incidences of infection, shortening of femoral neck and bone nonunion in group A were slightly lower than those in group B, and there were no statistically significant differences （P〉0.05）.The bone nonunion in group B mostly occurred among patients aged 50-55 years old, and the Harris score in group A was significantly higher than that in group B （P〈0.05）. Conclusion： Both of internal fixation with cannulated sc
出处
《广州医科大学学报》
2017年第1期49-52,共4页
Academic Journal of Guangzhou Medical University
关键词
股骨颈骨折
空心螺钉内固定术
空心钉锁定钢板
femoral neck fracture
internal fixation with cannulated screw
cannulated screw locking plate
