3枚空心钉结合支撑钢板与4枚空心钉在Pauwels Ⅲ型股骨颈骨折内固定的疗效对比
Comparison of 3 hollow nails combined with support plate and 4 hollow nails in internal fixation of femoral neck fracture of Pauwels type Ⅲ
汪洋 1丁鹏1
作者信息
- 1. 淮安市淮安医院骨科,江苏 淮安 223200
- 折叠
摘要
目的 探讨3枚空心钉结合支撑钢板与4枚空心钉在Pauwels Ⅲ型股骨颈骨折内固定的疗效.方法 回顾性分析2017年2月至2022年2月在淮安市淮安医院骨科就诊的92例Pau-wels Ⅲ型股骨颈骨折患者的临床资料.根据治疗方案不同将患者分为钉板结合组(39例)和单纯螺钉组(53例).随访1年,比较两组患者手术指标及恢复情况、股骨颈短缩情况、髋关节功能恢复情况及并发症发生率.结果 与单纯螺钉组相比,钉板结合组手术时间较长、失血量较多,骨愈合时间、完全负重时间则较短(P＜0.05).两组患者术后即刻、1年随访的股骨颈短缩情况比较,差异无统计学意义(P＞0.05).两组哈里斯髋关节评分量表(Harris Hip score,HHS)分值随着随访时间延长而增加(P＜0.05);两组术后1个月、3个月、6个月及1年的HHS评分比较,差异无统计学意义(P＞0.05).钉板结合组患者有3例发生并发症,单纯螺钉组7例,两组并发症总发生率比较差异无统计学意义(P＞0.05).结论 4枚空心钉和3枚空心钉结合支撑钢板对Pau-wels Ⅲ型股骨颈骨折治疗效果相当,均可明显改善患者髋关节功能,术后并发症少.3枚空心钉结合支撑钢板内固定骨折愈合时间及完全负重时间短,但4枚空心钉内固定手术时间短、出血量少,临床可依据具体情况选择合适的治疗方法.
Abstract
Objective To explore the effect of 3 hollow nails combined with support plate and 4 hollow nails in the internal fixation treatment of femoral neck fracture of Pauwels type Ⅲ.Methods Retrospective analysis was performed on the clinical data of 92 patients with type Ⅲ femoral neck fracture in the hospital from February 2017 to February 2022.According to different treatment plans,the patients were divided into screw binding group(39 cases)and screw alone group(53 cases).After 1 year of follow-up,the two groups were compared with surgical indicators and recovery,femoral neck shortening,hip functional re-covery and complication rate.Results Compared with the screw group alone,the operation time and blood loss were higher,and the bone healing time and full weight bearing time were shorter in the nis-plate group(P＜0.05).There was no significant difference in the shortening of femoral neck between the two groups(P＞0.05).The Harris Hip score(HHS)of 2 groups was increased with the extension of time(P＜0.05).There was no statistical significance in HHS scores of 1 month,3 months,6 months and 1 year after surgery between the two groups(P＞0.05).There were only 3 cases of complications in the screw binding group and 7 cases in the simple screw group,which did not reach statistical significance.There was no significant difference in the total incidence of complications between the two groups(P＞0.05).Conclusion 4 hollow nails and 3 hollow nails combined with supporting plate have similar efficacy in the treatment of Pauwels type Ⅲ femoral neck fracture,both can significantly improve hip joint function,less postoperative complications,the latter fracture healing time and complete weight-bearing time is short,but the former is short operation time and less blood loss,the clinical can choose the appropriate treatment method according to the specific situation.
关键词
股骨颈骨折/Pauwels/Ⅲ型/内固定/空心钉/支撑钢板Key words
femoral neck fracture/Pauwels Ⅲ type/internal fixation/hollow nail/supporting steel plate引用本文复制引用
基金项目
江苏省自然科学基金(BK20191212)
出版年
2023
NETL
NSTL
维普
万方数据