摘要
目的观察自主研发的新型导向器用于空心钉内固定治疗股骨颈骨折的疗效。方法回顾性分析2019年6月至2020年7月山西医科大学第二医院骨科采用空心钉内固定治疗的40例股骨颈骨折患者资料。根据是否应用新型导向器分为两组:导向组(20例,应用新型导向器)和徒手组(20例,徒手操作)。导向组男5例,女15例;年龄(48.4±10.2)岁(18~63岁);骨折Garden分型:Ⅰ、Ⅱ型12例,Ⅲ、Ⅳ型8例。徒手组男8例,女12例;年龄(49.8±8.4)岁(18~60岁);骨折Garden类型:Ⅰ、Ⅱ型13例,Ⅲ、Ⅳ型7例。所有骨折均行闭合复位3枚空心钉内固定。比较两组患者术中透视次数、手术时间、股骨皮质钻孔次数、正位上导针与股骨颈轴线夹角、侧位上导针与股骨颈轴线夹角、骨折愈合时间、Harris评分及并发症发生情况。结果两组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。导向组患者术中透视次数[(10.0±2.2)次]、手术时间[(41.8±5.6)min]、股骨皮质钻孔次数[(4.5±1.1)次]、正位上导针与股骨颈轴线夹角(3.0°±0.8°)、侧位上导针与股骨颈轴线夹角(3.9°±1.0°)、骨折愈合时间[(6.2±0.5)个月]显著少于徒手组[(24.8±8.3)次、(60.0±15.3)min、(12.8±2.0)次、7.2°±1.8°、7.6°±2.6°、(7.2±0.5)个月],差异均有统计学意义(P<0.05)。两组患者髋关节Harris评分比较差异均无统计学意义(P>0.05)。所有患者均无伤口感染、内固定移位、骨折不愈合、螺钉断裂等并发症发生。结论应用自主研发的导向器可以缩短手术时间及透视次数,降低股骨皮质钻孔次数,提高螺钉置入精确性。使用该导向器可使空心钉固定股骨颈骨折手术更加容易。
Objective To evaluate our self-designed novel guide device for cannulated screwing in the treatment of femoral neck fracture.Methods Between June 2019 and July 2020,40 patients with femoral neck fracture were treated with cannulated screwing at Department of Orthopaedics,The Second Hospital Affiliated to Shanxi Medical University.They were divided into a manual group of 20 cases whose cannulated screwing was implemented by hand and a guide group of 20 cases whose cannulated screwing was implemented with the aid of our self-designed guide device.In the guide group,there were 5 males and 15 females,with an age of(48.4±10.2)years(from 18 to 63 years);there were 12 cases of typesⅠ&Ⅱand 8 cases of typesⅢ&Ⅳby the Garden classification.In the manual group,there were 8 males and 12 females,with an age of(49.8±8.4)years(from 18 to 60 years);there were 13 cases of typesⅠ&Ⅱand 7 cases of typesⅢ&Ⅳby the Garden classification.All fractures underwent closed reduction and internal fixation with 3 cannulated screws.The intraoperative fluoroscopy,operation time,femoral cortex drilling,angle between the guide pin and the femoral neck axis in the anteroposterior view,angle between the guide pin and the femoral neck axis in the lateral view,fracture healing time,Harris hip score and complications were compared between the 2 groups.Results There was no significant difference in the preoperative general data between the 2 groups,showing comparability(P>0.05).In the guide group,intraoperative fluoroscopy[(10.0±2.2)times],operation time[(41.8±5.6)min],femoral cortex drilling[(4.5±1.1)times],angle between the guide pin and the femoral neck axis in the anteroposterior view(3.0°±0.8°)angle between the guide pin and the femoral neck axis in the lateral view(3.9°±1.0°)and fracture healing time[(6.2±0.5)months]were significantly less or smaller than those in the manual group[(24.8±8.3)times,(60.0±15.3)min,(12.8±2.0)times,7.2°±1.8°,7.6°±2.6°,and(7.2±0.5)months](all P<0.05).There was no significant differen
作者
任步方
吕欣
马全平
孙剑
Ren Bufang;Lyu Xin;Ma Quanping;Sun Jian(Department of Orthopaedics,The Second Hospital Affiliated to Shanxi Medical University,Taiyuan 030001,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2022年第4期328-333,共6页
Chinese Journal of Orthopaedic Trauma
关键词
股骨颈骨折
髋骨折
骨折固定术
内
导向器
Femoral neck fracture
Hip fracture
Fracture fixation,internal
Guide
