摘要
目的观察分析使用股骨重建钉治疗股骨颈骨折的临床效果。方法回顾性分析了长治市二院自2018年1月至2021年12月期间采用股骨重建钉治疗股骨颈骨折患者的临床资料,并与同期采用倒三角空心钉固定的患者进行对比。主要评价指标有两组患者的手术时间、出血量、术后2 d VAS评分、术后早期并发症及术后开始部分负重时间,并采用Harris评分评价髋关节功能。另外对患者骨折复位、愈合情况及股骨颈短缩程度进行评估。结果45例患者均获随访,随访时间9~18个月,平均(13.0±3.1)月。其中男27例,女18例,年龄从18~75岁。重建钉组患者手术时间及出血量分别为(82.7±16.2)min、35.00(30.00,50.00)ml均多于空心钉组的(64.0±18.2)min、17.50(13.75,30.00)ml(P<0.05);术后2 d VAS评分重建钉组[2.00(1.00,2.00)分]与空心钉组[2.00(1.00,2.00)分]无差异。空心钉组开始部分负重时间[8.00(6.00,10.00)周],晚于重建钉组[2.00(2.00,3.00)周](P<0.05)。髋关节Harris评分重建钉组[94.00(88.00,98.00)分]高于空心钉组[84.00(71.75,91.00)分](P<0.05)。术后定期复查X线片,空心钉组1例患者在随访期内未愈合,1例螺钉切出,1例未愈合并有股骨头坏死。重建钉组1例患者未愈合合并股骨头坏死。空心钉组骨折愈合时间[9.00(7.00,10.00)个月]与重建钉组[8.00(7.00,8.00)个月]无差异。空心钉组股骨颈短缩长度[4.00(2.00,7.00)mm]长于重建钉组[1.00(0.00,2.00)mm],(P<0.05)。结论使用股骨重建钉固定股骨颈骨折具有明显的临床优势,如可早期负重、股骨颈短缩程度轻、髋关节功能好等,且股骨重建钉的临床应用时间长、技术成熟,易于推广。
Objective To investigate the clinical effect of femoral reconstruction nail in the treatment of femoral neck fractures.Methods A retrospective analysis was performed on 45 patients with femoral neck fractures in our hospital from January 2018 to Decemberr 2021.There were 30 patients in the CCS group and 15 patients in the femoral reconstruction nail group,with range 18 to 75 years.The main evaluation indicators for both groups of patients include surgical time,bleeding volume,VAS score at 2 days after surgery,early postoperative complications,and time to start partial weight-bearing after surgery,Harris score of the hip joint,fracture reduction,healing status,and degree of femoral neck shortening.Results 45patients were followed up for 9 to 18 months,mean(13.0±3.1)months.There were 27 males and 18 females,with range 18 to 75.Both groups showed the average operation time was[(64±18.2)vs(82.7±16.2)min,P<0.05],the median bleeding volume was[17.50(13.75,30.00)vs 35.00(30.00,50.00)ml,P<0.001],the median VAS score at 2 days after surgery was[2.00(1.00,2.00)vs 2.00(1.00,2.00),P=0.227],the median postop-erative partial weight-bearing time was[8.00(6.00,10.00)vs 2.00(2.00,3.00)weeks,P<0.001],the median hip joint Harrisscore was[84.00(71.75,91.00)vs 94.00(88.00,98.00),P<0.05],the median fracture healing time was[9.00(7.00,10.00)vs 8.00(7.00,8.00)months,P=0.075],the median femoral neck shortening length was[4.00(2.00,7.00)vs 1.00(0.00,2.00)mm,P<0.001].Among them,a patient in the CCS group did not heal during the follow-up period,a patient had screw penetration,and a patient did not heal with femoral head necrosis.A patient in the femoral reconstruction nail group did not heal with femoral head necrosis.Conclusion The fixation of femoral neck fractures with femoral reconstruction nails has significant clinical advantages,such as early weight bearing,mild shortening of the femoral neck,and good hip joint function.In addition,femoral reconstruction nails are a mature technology that has a long clinical application time and
作者
宋晓亮
郝海虎
刘渊
李浩江
雷晓晶
邵新中
李卿源
Song Xiaoliang;Hao Haihu;Liu Yuan;Li Haojiang;Lei Xiaojing;Shao Xinzhong;Li Qingyuan(Department of Trauma Orthopaedics,Changzhi Second People's Hospital,Changzhi 046000,China;Department of Trauma Orthopaedics,Shanxi Norman Bethune Hospital,Taiyuan 030000,China;Department of Trauma Orthopaedics,Handan First Hospital,Handan 056000,China;Department of Hand Surgery,The Third Hospital of Hebei Medical University,Shijiazhuang 050011,China;Department of Hand Microsurgery,Tianjin Hospital,Tianjin 300220,China)
出处
《中华老年骨科与康复电子杂志》
2023年第4期201-208,共8页
Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)
基金
山西省科技厅自然科学研究面上项目(202103021224347)。
关键词
股骨颈骨折
股骨重建钉
空心钉
股骨头坏死
股骨颈短缩
Femoral neck fracture
Femoral reconstruction nail
Cannulate compression screw
Femoral head necrosis
Femoral neck shortening
