摘要
目的:探讨直接前侧入路(DAA)切开复位内固定治疗青壮年股骨颈骨折的治疗效果。方法:回顾性分析2017年1月至2020年12月行股骨颈骨折内固定手术治疗的青壮年患者42例病例,按治疗方法不同分为两组:直接前侧入路组20例采用直接前侧入路直视下复位骨折,经皮空心钉内固定;闭合复位组22例采用传统闭合复位空心钉内固定。结果:两组一般资料差异无统计学意义(P>0.05),具有可比性。闭合复位组在手术时间((75.05±7.280)min)和出血量((55.35±15.989)mL)方面优于直接前侧入路组(分别为(102.41±17.866)min和(123.50±35.525)mL)(P<0.001)。术后Garden复位指数直接前侧入路组优于闭合复位组(P=0.033);术后3个月和12个月Harris评分优良率闭合复位组低于直接前侧入路组(P=0.030,P=0.031)。2年内直接前侧入路组股骨头坏死率低于闭合复位组(P=0.028),两组骨折不愈合率差异无统计学意义(P=0.179)。结论:股骨颈骨折采用直接前侧入路切开复位内固定治疗可在直视下完成骨折复位,术中创伤小,复位效果好,有利于患者的肢体功能恢复及减少术后并发症。
Objective:To explore the efficacy of direct anterior approach(DAA)for open reduction and internal fixation on the treatment of femoral neck fractures in young and middle-aged patients.Methods:A retrospective analysis was conducted on 42 cases young and middle-aged patients who underwent internal fixation for femoral neck fracture from January 2017 to December 2020.We divided them into two groups according to different treatment methods,one of which was DAA group and the other group was closed reduction group.In the DAA group,there are 20 cases,20 patients were treated with direct anterior approach,reduction under direct vision,and percutaneous cannulated screws internal fixation.In the closed reduction group,there are 22 cases,22 patients were treated with traditional closed reduction and cannulated screw internal fixation.Results:There was no statistically significant difference in general data between the two groups(P>0.05).The operation time and intraoperative blood loss in the closed reduction group((75.05±7.280)min,(55.35±15.989)mL)were less than those in the DAA group((102.41±17.866)min,(123.50±35.525)mL)(P<0.001).DAA group had better Garden reduction index than closed reduction group(P=0.033).The excellent and good rate of Harris score at 3 and 12 months after operation in closed reduction group was lower than that in DAA group(P=0.030,P=0.031).The rate of femoral head osteonecrosis in the DAA group was lower than that in the closed reduction group within 2 years(P=0.028).The fracture nonunion rate between the two groups was no statistical significance(P=0.179).Conclusion:DAA for open reduction and internal fixation for femoral neck fractures can achieve fracture reduction under direct vision,with less intraoperative trauma and good reduction efficacy,promoting the recovery of limb function and reducing postoperative complications.
作者
吴聪
阮鹏飞
邵威捷
沈景
季卫锋
WU Cong;RUAN Pengfei;SHAO Weijie;SHEN Jing;JI Weifeng(The First Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310053,China)
出处
《中国中医骨伤科杂志》
CAS
2023年第4期69-72,共4页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
股骨颈骨折
青壮年患者
直接前方入路
切开复位
内固定
femoral neck fracture
young and middle-aged patients
direct anterior approach
open reduction
internal fixation
