摘要
目的 比较不同安放位置的股骨颈动力交叉钉系统(FNS)联合空心螺钉治疗不稳定型股骨颈骨折的手术效果。方法 回顾性分析2019年9月—2022年8月新疆医科大学第六附属医院创伤骨一科收治的不稳定型股骨颈骨折患者126例,男性54例,女性72例;年龄33~65岁,平均44.6岁;致伤原因:跌倒伤86例,道路交通伤21例,高处坠落伤19例。根据术后复查X线片中FNS动力棒的位置以及是否联合空心螺钉将其分为三组。A组FNS动力棒置于股骨头中1/3(59例);男性30例,女性29例;年龄34~64岁,平均46.6岁。B组FNS动力棒置于股骨头下1/3(39例);男性13例,女性26例;年龄33~63岁,平均41.7岁。C组FNS动力棒置于股骨头下1/3联合1枚空心螺钉(28例);男性11例,女性17例;年龄33~65岁,平均43.9岁。所有患者术后至少随访1年。观察和比较三组患者一般资料、手术相关结局指标、住院期间和近期手术并发症以及末次随访时Harris髋关节功能评分(HHS)。结果 C组患者术中透视次数(32.1±7.9)次显著多于其余两组[A组:(24.6±4.2)次;B组:(24.9±6.2)次],差异有统计学意义(P<0.05);C组术后无髋内翻发生,A组12例、B组5例发生髋内翻,三组间比较差异有统计学意义(P<0.05);C组患者术后开始负重时间(10.8±1.4)d显著短于其余两组[A组:(11.6±1.7)d;B组:(12.1±1.6)d],三组间差异有统计学意义(P<0.05);C组患者骨折愈合时间(15.1±1.1)周,显著少于其余两组[A组:(15.8±1.5)周;B组:(16.1±1.4)周],三组间差异有统计学意义(P<0.05)。三组间其余结局指标比较,差异均无统计学意义(P>0.05)。结论 相较于单独使用FNS,“FNS+空心钉”虽然会增加X线透视次数,但其治疗不稳定型股骨颈骨折术后可能会有更好的疗效。
Objective To compare the surgical effect of different locations of the femoral neck system(FNS)combined with cannulated screws(CS)in the treatment of unstable femoral neck fractures.Methods A retrospective analysis was made on 126 patients with unstable femoral neck fractures treated in the First Department of Traumatic Orthopaedics,the Sixth Affiliated Hospital of Xinjiang Medical University from Sep.2019 to Aug.2022,including 54 males and 72 females aged 33-65(mean 44.6)years.The causes of injury were ground-level falls in 86 cases,road traffic injuries in 21 and falls from height in 19.According to the position of the FNS power rod detec-ted by immediate postoperative X-rays and whether cannulated screws were combinedly used,patients were divided into groups A,B and C.In group A,the FNS power rod was located in the middle 1/3 of the femoral head and no use of CS(with 59 cases,including 30 males and 29 females aged 34-64 years,mean 46.6 years).In group B,the FNS power rod was located in the inferior 1/3 of the femoral head and no use of CS(with 39 cases,including 13 males and 26 females aged 33-63 years,mean 41.7 years).In group C,the FNS power rod was located in the inferior 1/3 of the femoral head combined with the use of CS(with 28 cases,including 11 males and 17 females aged 33-65 years,mean 43.9 years).All patients were followed up for at least 1 year.The general clinical data,operation-related characteristics,hospitalization and short-term operative complications,and Harris hip function score(HHS)at the last follow-up were observed and compared among the three groups.Results Compared with groups A and B,group C revealed much more times of intraoperative fluoroscopy(32.1±7.9 vs.24.6±4.2 and 24.9±6.2),less inci-dence of hip varus(0 vs.12/39 and 5/28),and earlier weight bearing start time(d,10.8±1.4 vs.11.6±1.7 and 12.1±1.6)and fracture healing(weeks,15.1±1.1 vs.15.8±1.5 and 16.1±1.4),all revealing statistically signifi-cant differences(all P<0.05).Other outcome indexes showed no significant differe
作者
吐松江·玉苏普
阿里木江·玉素甫
冉建
Tusongjiang·Yusupu;Alimujiang·Yusufu;Ran Jian(First Department of Traumatic Orthopaedics,the Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi830002,China)
出处
《创伤外科杂志》
2024年第7期534-541,共8页
Journal of Traumatic Surgery
