摘要
目的探究采用股骨颈动力交叉钉系统(FNS)治疗股骨颈骨折其内固定位置与术后临床疗效的相关性。方法回顾性分析自2019年1月至2022年4月于苏州市立医院关节外科采用FNS治疗的GardenⅣ型股骨颈骨折且获得完整随访的患者60例,分析所有患者的影像学资料,利用术后CT及X片测量并计算FNS动力棒末端相对于股骨头颈中心轴线偏移程度和尖顶距(TAD)。所有患者随访至少一年,并在末次随访时复查骨盆X片测量股骨颈短缩长度并采用髋关节Harris评分评估临床疗效,分析动力棒位置偏移程度、TAD、末次随访时股骨颈短缩长度、髋关节Harris评分之间的相关性。结果所有患者均获得随访,随访时间(20.55±5.89)个月。男性27例,女性33例,平均年龄(45.48±10.09)岁。TAD(r=0.327,P<0.05)及末次随访时股骨颈短缩长度(r=0.310,P<0.05)均与术后动力棒末端相对于股骨头颈中心轴线的偏移程度呈显著正相关;而末次随访时髋关节Harris评分与术后动力棒末端相对于股骨头颈中心轴线的偏移程度呈显著负相关(r=-0.275,P<0.05)。末次随访时股骨颈短缩长度与TAD呈显著正相关(r=0.278,P<0.05),而末次随访时髋关节Harris评分与TAD呈显著负相关(r=-0.314,P<0.05),并与末次随访时股骨颈短缩长度呈显著负相关(r=-0.282,P<0.05)。结论采用FNS内固定治疗股骨颈骨折,当结合适宜的TAD时,将动力棒尽可能靠近股骨头颈中心轴线置入,术后可能获得更好的临床疗效。
Objective To explore the correlation between the postoperative clinical efficacy of femoral neck system(FNS)in the treatment of femoral neck fractures and the position of internal fixation.Methods Sixty patients with Garden typeⅣfemoral neck fracture treated with FNS in the Department of Orthopedics,Suzhou Municipal Hospital from January 2019 to April 2022 were included and were followed up completely.The imaging data of all patients were analyzed retrospectively.Postoperative CT and X-ray imaging were used to measure and calculate the deviation degree of the end of the FNS screw bolt relative to the central axis of the femoral head and neck and the tip-apex distance(TAD).All patients were followed up for at least 1 year.At the last follow-up,pelvic X-ray imaging was used to measure the femoral neck shortening length,and Harris hip score was used to evaluate the postoperative clinical efficacy.The correlation between the deviation degree of FNS screw bolt and TAD,femoral neck shortening length and Harris hip score at the last follow-up were analyzed.Results All patients were followed up for(20.55±5.89)months.There were 27 males and 33 females,with a mean age of(45.48±10.09)years.Both TAD(r=0.327,P<0.05)and femoral neck shortening length at the last follow-up(r=0.310,P<0.05)were significantly positively correlated with the deviation+degree of the end of the FNS screw bolt relative to the central axis of the femoral head and neck.The Harris hip score at the last follow-up was significantly negatively correlated with the deviation of the end of the FNS screw bolt relative to the central axis of the femoral head and neck(r=-0.275,P<0.05).Femoral neck shortening length at the last follow-up was significantly positively correlated with TAD(r=0.278,P<0.05).The Harris hip score at the last follow-up was significantly negatively correlated with TAD(r=-0.314,P<0.05)and femoral neck shortening length at the last follow-up(r=-0.282,P<0.05).Conclusion In the treatment of femoral neck fractures with femoral neck system,the
作者
金宇杰
虞宵
周晓强
李志强
徐人杰
张向鑫
陈广祥
Jin Yujie;Yu Xiao;Zhou Xiaoqiang;Li Zhiqiang;Xu Renjie;Zhang Xiangxin;Chen Guangxiang(Department of Orthopedics,Gusu School,Nanjing Medical University,The Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou Municipal Hospital,Suzhou 215000,China)
出处
《中华老年骨科与康复电子杂志》
2023年第4期193-200,共8页
Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)
基金
南京医科大学姑苏学院青年骨干科学研究培育专项(GSKY20220521)
苏州市第十二批科技发展计划项目(SLJ2021020)。
