摘要
目的探讨不同数量空心钉运用于股骨颈骨折内固定术的疗效。方法回顾性分析上海中医药大学附属龙华医院金山分院2016年4月至2019年4月采用闭合复位空心钉内固定治疗的20例股骨颈骨折患者临床资料,以其中11例采用倒“品”字3枚7.3 mm空心钉内固定的患者作为对照组,以另9例采用倒“品”字3枚空心钉加1枚横向6.5 mm空心钉内固定的患者作为研究组。所有患者均进行6~12个月的随访,记录两组出血量及手术、术后负重、住院及骨折愈合时间,观察并发症如股骨头坏死、肢体短缩、骨折不愈合、髋内翻畸形发生情况并计算发生率,分别在手术前及手术后3个月、6个月进行Harris髋关节功能评分,并进行手术前后生活质量(QOL)评分。结果研究组手术时间长于对照组,术中出血量大于对照组,但术后负重、住院及骨折愈合时间均短于对照组(P<0.05)。研究组并发症发生率为22.22%,明显低于对照组(36.36%,P<0.05)。两组术前Harris髋关节功能评分差异无统计学意义(P>0.05),但术后3个月、6个月Harris髋关节功能评分均高出术前(P<0.05),术后3个月、6个月两组Harris髋关节功能评分差异无统计学意义(P>0.05)。两组术前QOL评分差异无统计学意义(P>0.05),术后各项评分均较术前明显升高(P<0.05),但研究组术后食欲、精神、睡眠、疲乏、疼痛、日常生活评分均高于对照组(P<0.05)。结论采用3枚空心钉加1枚横向空心钉内固定治疗股骨颈骨折效果明显,可有效保证力学稳定性,减少卧床时间,促进髋关节功能恢复,降低并发症发生率,提高生存质量。
Objective To compare the efficacy of femoral neck fractures fixed with different number of cannulated screws.Methods A total of 20 patients suffering femoral neck fractures treated with closed reduction and internal fixation with cannulated screws from April 2016 to April 2019 in our hospital were retrospectively reviewed.Eleven cases treated with three 7.3 mm cannulated screws in a triangle configuration were considered as the control group,while the rest 9 cases were allocated into the research group treated with a 6.5 mm cannulated screw in the horizontal intertrochanteric direction on the basis of three 7.3 mm cannulated screws as same as the control group.All patients were followed for six to twelve months.The blood loss volume,operation duration,postoperative weight-bearing time,days of hospital stay and bone union time were recorded;complications including osteonecrosis of the femoral head,limb shortening,facture nonunion and coxa vara deformity as well as Harris joint scores before surgery,after three months and six months of surgery,and quality of life(QOL)scores were calculated.Results Compared with the control group,the research group had significantly longer operation duration and more blood loss volume,but had shorter weight-bearing time,hospital stay and bone union time(all P<0.05);the complication rate in the research group(22.22%)was significantly lower than that in the control group(36.36%,P<0.05);no significant difference was found between both groups in terms of Harris scores pre-operatively,three months,or 6 months post-operatively(all P>0.05),but the Harris scores were improved significantly in both groups at 3 months and 6 months post-operatively,compared with those pre-operatively(all P<0.05);there was no statistically significant difference in QOL scores between the two groups before surgery(P>0.05),and the postoperative scores were significantly higher than those before surgery(P<0.05),but the scores of appetite,spirit,sleep,fatigue,pain and daily life in the research group were significa
作者
罗卢华
沈洪晖
杨坚
吴仕旺
杜健
孔菲
顾铁军
仇建军
LUO Luhua;SHEN Honghui;YANG Jian;WU Shiwang;DU Jian;KONG Fei;GU Tiejun;QIU Jianjun(Department of Orthopaedics,Jinshan Branch,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201501,China;Department of Radiology,Jinshan Branch,Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201501,China;Department of Orthopaedics,Putuo Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China)
出处
《国际骨科学杂志》
2021年第1期59-64,共6页
International Journal of Orthopaedics
关键词
空心钉
内固定
股骨颈骨折
疗效
Cannulated screws
Fixation
Femoral neck fractures
Efficacy
