首页|两种内固定治疗Pauwels Ⅲ型股骨颈骨折的疗效比较

两种内固定治疗Pauwels Ⅲ型股骨颈骨折的疗效比较

Efficacy comparison of two kinds of internal fixation for treatment of Pauwels type Ⅲ femo-ral neck fracture

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  • 国家科技期刊平台
  • NETL
  • NSTL
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目的 比较股骨颈动力交叉钉系统(FNS)与4 枚空心加压螺钉(FCCS)内固定治疗Pauwels Ⅲ型股骨颈骨折的疗效.方法 将52 例Pauwels Ⅲ型股骨颈骨折患者根据内固定方式不同分为FNS组(采用FNS内固定治疗,25 例)和FCCS组(采用FCCS内固定治疗,27 例).记录两组手术情况、骨折复位及愈合情况、并发症发生情况,采用Harris评分标准评价髋关节功能.结果 患者均获得随访,时间 10～24 个月.手术时间、术中透视次数FNS组短(少)于FCCS组(P<0.05),切口长度、术中出血量FNS组长(多)于FCCS组(P<0.05),住院时间两组比较差异无统计学意义(P>0.05).术后采用Garden指数评价骨折复位质量,两组比较差异无统计学意义(P>0.05).骨折愈合时间两组比较差异无统计学意义(P>0.05).下肢静脉血栓、股骨头缺血性坏死发生率两组比较差异均无统计学意义(P>0.05),大腿外侧激惹症状发生率FCCS组高于FNS组(P<0.05).末次随访时Harris评分优良率FNS组高于FCCS组(P<0.05).结论 FNS和FCCS内固定治疗Pauwels Ⅲ型股骨颈骨折均可获得较好的临床疗效,FNS内固定整体结构稳定性较高,操作更简便,手术时间更短,术中透视次数更少,术后大腿外侧激惹症状发生率低,早期疗效更好.
Objective To compare the efficacy of femoral neck system(FNS)and four cannulated compression screws(FCCS)in the treatment of Pauwels type Ⅲ femoral neck fracture.Methods The 52 patients with Pauwels typeⅢfemoral neck fractures were divided into FNS group(FNS internal fixation treatment,25 cases)and FCCS group(FCCS internal fixation treatment,27 cases)according to different internal fixation methods.The operation condi-tions,fracture reduction,fracture healing and complications were recorded in the two groups.The Harris score was used to evaluate hip function.Results All patients were followed up for 10～24 months.Operation time and intraop-erative fluoroscopy frequency in FNS group were shorter(less)than those in FCCS group(P<0.05),FNS group was longer(more)than FCCS group in the incision length and intraoperative blood loss(P<0.05),and there was no sta-tistical difference in hospitalization time between the two groups(P>0.05).Garden index was used to evaluate the quality of fracture reduction after surgery,and there was no statistical difference between the two groups(P>0.05).The healing time had no statistical difference between two groups(P>0.05).There were no statistical differences in the incidence rate of lower extremity venous thrombosis and avascular necrosis of femoral head between the two groups(P>0.05),and there were statistical differences in the incidence of lateral thigh irritation between the two groups(P<0.05).At the last follow-up,the excellent-good rate of Harris score in FNS group was higher than that in FCCS group(P<0.05).Conclusions Both FNS and FCCS internal fixation can obtain good clinical efficacy in the treat-ment of Pauwels type Ⅲ femoral neck fracture.FNS internal fixation has higher overall structural stability,easier oper-ation,shorter operation time,fewer intraoperative fluoroscopy frequency,lower incidence rate of postoperative lateral thigh irritation symptoms,and better early efficacy.

Pauwels type Ⅲ femoral neck fracturesfemoral neck systemfour cannulated compression screws

刘英科、陈勤、陈柯、马文龙、田可为、范克杰、田燃、邝孝坤

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河南中医药大学研究生院,河南 郑州 450000

河南省洛阳正骨医院(河南省骨科医院)髋关节外科,河南 洛阳 471002

Pauwels Ⅲ型股骨颈骨折 股骨颈动力交叉钉系统 4 枚空心加压螺钉

河南省卫生健康委医学科技攻关计划联合共建项目河南省中医管理局中医药科研专项河南省中医管理局中医药科研专项河南省中医管理局中医药科研专项河南省洛阳市科技局核心技术攻关类公益专项

LHGJ202304832023ZY102220-21ZY223820-21ZY22532302053Y

2024

10.3969/j.issn.1008-0287.2024.02.030

临床骨科杂志
安徽医科大学，安徽省医学会

临床骨科杂志

CSTPCD
影响因子：1.438
ISSN：1008-0287
年,卷(期)：2024.27(2)
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