摘要
目的 对比分析股骨颈动力交叉钉系统(FNS)固定与空心加压螺钉(CCS)固定治疗中青年股骨颈骨折的临床疗效.方法 选取 2019 年 4 月至 2021 年 4 月新郑华信民生医院收治的 140 例中青年股骨颈骨折患者作为研究对象,按照不同治疗方法将其分为FNS组(67 例)和CCS组(73 例),FNS组患者行FNS固定治疗,CCS组患者行CCS固定治疗,对比观察两组患者术中出血量、术中透视次数、手术时间、住院时间、术后完全负重开始时间等手术相关情况与骨折愈合情况,以及疼痛程度、股骨颈短缩长度、日常生活能力、髋关节功能与不良事件发生情况.结果 FNS组患者术中出血量和住院时间与CCS组无明显差异(t=1.379、0.411,P= 0.170、0.682),术中透视次数明显少于CCS组(t=12.682,P＜0.001),手术时间、术后完全负重开始时间及骨折愈合时间均明显短于CCS组(t=8.789、8.418、8.177,P均＜0.001);术后 6 个月,FNS组患者视觉模拟评分法(VAS)评分明显低于 CCS 组(t= 6.835,P＜0.001),股骨颈短缩长度明显短于 CCS 组(t = 10.252,P＜0.001),Barthel指数评分与Harris评分均明显高于CCS组(t=8.158、11.051,P均＜0.001).FNS组患者术后不良事件发生率为 8.96%,明显低于CCS组患者的术后不良事件发生率 24.66%(χ2 = 6.064,P= 0.014).结论 与CCS固定相比,FNS固定更能明显减少中青年股骨颈骨折患者术中透视次数,缩短手术时间、术后完全负重开始时间和骨折愈合时间,减轻患者疼痛及股骨颈短缩程度,促进髋关节功能恢复,提高患者日常生活能力,降低术后不良事件发生风险,临床应用价值更高.
Abstract
Objective To compare the clinical efficacy of femoral neck system(FNS)fixation and cannulated compression screw(CCS)fixation in young and middle-aged patients with femoral neck fractures.Methods 140 young and middle-aged patients with femoral neck fractures,admitted to Hopeshine Minsheng Hospital of Xinzheng from April 2019 to April 2021,were enrolled into the study and divided into FNS group(n=67),receiving FNS fixation,and CCS group(n= 73),receiving CCS fixation,and the following items were compared between the two groups,including surgery-related indi-cators,i.e.,intraoperative blood loss volume,times of intraoperative fluoroscopy,operation time,length of stay,postoper-ative full weight-bearing start time,as well as fracture healing condition,pain intensity,shortened length of femoral neck,activities of daily living,hip joint function,and occurrences of postoperative adverse events.Results There were no signifi-cant differences between the FNS group and the CCS group in terms of intraoperative blood loss volume and length of stay(t=1.379 and 0.411,P=0.170 and 0.682). The times of intraoperative fluoroscopy in the FNS group were significantly less than that in the CCS group(t=12.682,P＜0.001),and the operation time and fracture healing time were significantly shorter(t=8.789 and 8.418,both P＜0.001),and the postoperative full weight-bearing start time was notably earlier(t= 8.177,P＜0.001)in the FNS group.Six months after surgery,the visual analogue scale(VAS)scores were significantly lower(t=6.835,P＜0.001),and the shortened length of femoral neck was significantly less(t=10.252,P＜0.001)in the FNS group compared with the CCS group.Additionally,both Barthel index scores and Harris scores were significantly higher in the FNS group(t=8.158 and 11.051,both P＜0.001).The incidence of postoperative adverse events was 8.96%in the FNS group,being significantly lower than 24.66%in the CCS group(χ2=6.064,P=0.014).Conclusion Compared with CCS fixation,FNS fixation,in the treatment of femoral neck fracture in young and middle-aged patients,is superior in that it can significantly reduce times of intraoperative fluoroscopy,shorten operation time and fracture healing time,initiate earlier postoperative full weight-bearing exercises,alleviate patients'pain and femoral neck shortening,and promote the recovery of hip joint function,thus improving patients'activities of daily living and lowering the risk of postoperative adverse events.
维普
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