临床和实验医学杂志2024，Vol.23Issue(8) ：838-841.DOI:10.3969/j.issn.1671-4695.2024.08.015

股骨颈固定系统固定与空心螺钉内固定治疗股骨颈骨折的疗效观察

Observation on the therapeutic effect of femoral neck fixation system and cannulated compression screws internal fixation in the treat-ment of femoral neck fractures

吴聪 刘伦 贾全忠
临床和实验医学杂志2024，Vol.23Issue(8) ：838-841.DOI:10.3969/j.issn.1671-4695.2024.08.015
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股骨颈固定系统固定与空心螺钉内固定治疗股骨颈骨折的疗效观察

Observation on the therapeutic effect of femoral neck fixation system and cannulated compression screws internal fixation in the treat-ment of femoral neck fractures

吴聪 1刘伦 1贾全忠1
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作者信息

  • 1. 四川绵阳四0四医院骨科 四川 绵阳 621000
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摘要

目的 观察股骨颈固定系统(FNS)固定与空心螺钉(CCS)内固定治疗股骨颈骨折的疗效.方法 回顾性分析2020年2月至2023年1月四川绵阳四0四医院骨伤外科收治的股骨颈骨折患者的临床资料,按照内固定方式的不同分为FNS组(n=40)和CCS组(n=40).两组术前常规治疗及术后处理相同,FNS组实施FNS内固定治疗,CCS组实施CCS内固定治疗.两组均随访至术后6个月,比较两组手术相关指标(手术时间、术中出血量、切口长度、术中透视次数、术后完全负重时间及住院时间)、骨折复位质量(Garden对线指数)、骨折愈合时间、髋关节功能恢复(Harris量表),并记录治疗及随访期间并发症发生情况.结果 FNS组的手术时间、切口长度及术后完全负重时间分别为(47.52± 9.43)min、(4.33±0.41)cm、(11.13±1.88)周,均短于 CCS 组[(67.45±12.84)min、(3.42±0.38)cm、(14.67± 1.74)周],术中出血量及术中透视次数分别为(26.47±7.56)mL、(12.72±1.83)次,均少于CCS组[(43.58±10.62)mL、(17.41±2.64)次],差异均有统计学意义(P＜0.05);两组住院时间比较,差异无统计学意义(P＞0.05).术后6个月,FNS组Garden对线指数分型优于CCS组,差异有统计学意义(P＜0.05);两组骨折愈合时间比较,差异无统计学意义(P＞0.05).术后6个月,FNS组股骨颈缩短程度优于CCS组,差异有统计学意义(P＜0.05).术后6个月,两组Harris评分均较术前升高,且FNS组Harris评分为(83.67±11.52)分,高于CCS组[(77.47±10.38)分],差异均有统计学意义(P＜0.05).两组治疗及随访期间总并发症发生率比较,差异无统计学意义(P＞0.05).结论 FNS与CCS均对股骨颈骨折有较好的疗效,但与CCS相比,FNS可进一步缩短手术时间,减少术中出血量,使患者尽快完全负重,并能明显改善骨折复位质量及髋关节功能.

Abstract

Objective To observe the therapeutic effect of femoral neck fixation system(FNS)and cannulated compression screws(CCS)internal fixation in the treatment of femoral neck fracture.Methods The clinical data of patients with femoral neck fracture admitted to Si-chuan Mianyang 404 Hospital from February 2020 to January 2023 were retrospectively analyzed.According to the different internal fixation meth-ods,they were divided into the FNS group(n=40)and the CCS group(n=40).The preoperative routine treatment and postoperative treat-ment of the two groups were the same.The FNS group was treated with FNS internal fixation,and the CCS group was treated with CCS internal fix-ation.The two groups were followed up to 6 months after operation.The operation related indexes(operation time,intraoperative blood loss,inci-sion length,intraoperative fluoroscopy times,postoperative full weight-bearing time and hospitalization time),fracture reduction quality(Garden alignment index),fracture healing time,hip function recovery(Harris scale)were compared between the two groups,and the complications dur-ing treatment and follow-up were recorded.Results The operation time,incision length,and postoperative full weight-bearing time of the FNS group were(47.52±9.43)minutes,(4.33±0.41)cm,and(11.13±1.88)weeks,respectively,which were shorter than those of the CCS group[(67.45±12.84)minutes,(3.42±0.38)cm,and(14.67±1.74)weeks],the intraoperative bleeding volume and intraoperative fluo-roscopy frequency were(26.47±7.56)mL and(12.72±1.83)times,respectively,which were lower than those of the CCS group[(43.58± 10.62)mL and(17.41±2.64)times],and the differences were statistically significant(P＜0.05).There was no statistically significant difference in hospitalization time between the two groups(P＞0.05).After 6 months of operation,the Garden line index classification in the FNS group was better than that in the CCS group,and the difference was statistically significant(P＜0.05);there was no statistically significant difference in the fracture healing time between the two groups(P＞0.05).At 6 months after operation,the femoral neck shortening in the FNS group was better than that in the CCS group,and the difference was statistically significant(P＜0.05).After 6 months of operation,the Harris scores of two groups were higher than those before surgery,and the Harris score of the FNS group was(83.67±11.52)points,which was higher than that of the CCS group[(77.47±10.38)points],and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the incidence of total complications between the two groups during treatment and follow-up(P＞0.05).Conclusion Both FNS and CCS are effective in the treatment of femoral neck fracture.However,compared with CCS,FNS can further shorten the operation time,reduce the amount of intraoperative blood loss,make the patients fully loaded as soon as possible,and significantly improve the quality of fracture reduction and hip joint function.

关键词

股骨颈骨折/内固定术/股骨颈内固定系统/空心螺钉/髋关节功能

Key words

Femoral neck fracture/Internal fixation/Femoral neck internal fixation system/Hollow screw/Hip joint function

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基金项目

四川省卫生和计划生育委员会科研项目(YDS-15172384)

出版年

2024
临床和实验医学杂志
首都医科大学附属北京友谊医院

临床和实验医学杂志

CSTPCD
影响因子：1.504
ISSN：1671-4695
参考文献量21
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