[1]贾川,俞伟忠,王雨辰,等.空心钉钢板与动力抗旋交叉钉治疗中青年股骨颈骨折的疗效对比[J].中国中医骨伤科杂志,2023,31(12):43-48.[doi:10.20085/j.cnki.issn1005-0205.231209]
　JIA Chuan,YU Weizhong,WANG Yuchen,et al.Comparison of the Efficacy of Hollow Nail Steel Plate and Femoral Neck System on the Treatment of Femoral Neck Fracture in Young and Middle-Aged Patients[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(12):43-48.[doi:10.20085/j.cnki.issn1005-0205.231209]
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空心钉钢板与动力抗旋交叉钉治疗中青年股骨颈骨折的疗效对比()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年12期
页码:
43-48
栏目:
临床研究
出版日期:
2023-12-15

文章信息/Info

Title:
Comparison of the Efficacy of Hollow Nail Steel Plate and Femoral Neck System on the Treatment of Femoral Neck Fracture in Young and Middle-Aged Patients
文章编号:
1005-0205(2023)12-0043-06
作者:
贾川1; 俞伟忠1; 王雨辰1; 吴国明1; 高华1; 潘佳麟1△
1常州市武进中医医院骨伤科(江苏 常州,213161)
Author(s):
JIA Chuan1; YU Weizhong1; WANG Yuchen1; WU Guoming1; GAO Hua1; PAN Jialin1△
1Department of Traumatic Orthopaedics,Wujin Hospital of Traditional Chinese Medicine,Changzhou 213161,Jiangsu China.
关键词:
空心钉钢板;  动力抗旋交叉钉;  中青年股骨颈骨折;  疗效分析
Keywords:
hollow nail steel plate;  femoral neck system;  femoral neck fracture in young and middle-aged patients;  curative efficacy analysis
分类号:
R683.42
DOI:
10.20085/j.cnki.issn1005-0205.231209
文献标志码:
A
摘要:
目的:探讨空心钉钢板与动力抗旋交叉钉(FNS)应用于中青年股骨颈骨折的疗效。方法:回顾性分析2020年7月至2022年6月采用闭合复位空心钉钢板与动力抗旋交叉钉治疗的48例股骨颈骨折患者临床资料。以其中26例采用空心钉钢板内固定的患者作为空心钉钢板组,采用动力抗旋交叉钉内固定的22例患者作为动力抗旋交叉钉组。所有患者均进行6～22个月的随访,记录两组患者切口长度、术中出血量、手术时间、术后负重、住院及骨折愈合时间,同时记录两组患者骨折复位质量、股骨颈短缩距离及股骨头后倾角,观察并发症(如股骨头坏死、肢体短缩、骨折不愈合、髋内翻畸形及大粗隆外侧慢性疼痛)发生情况并计算发生率,分别在手术前和术后次日、1个月、3个月及6个月进行Harris髋关节功能评分。结果:空心钉钢板组较动力抗旋交叉钉组术中出血量更多,手术时间更长,切口长度更长,差异有统计学意义(P<0.05),但术中透视次数及骨折愈合时间差异无统计学意义(P>0.05)。两组患者术后各时段Harris髋关节功能评分均优于术前,差异有统计学意义(P<0.05); 且术前及术后各时段评分相近,差异无统计学意义(P>0.05)。两组患者骨折复位质量差异无统计学意义(P>0.05),空心钉钢板组股骨颈短缩距离及股骨头后倾角均小于动力抗旋交叉钉组,差异有统计学意义(P<0.05)。空心钉钢板组术后发生肢体短缩1例,骨折延迟愈合2例,大粗隆外侧慢性疼痛5例,并发症发生率为30.77%。动力抗旋交叉钉组术后发生肢体短缩2例,骨折延迟愈合2例,髋內翻畸形3例,并发症发生率为31.81%。两组并发症发生率差异无统计学意义(P>0.05)。结论:动力抗旋交叉钉与空心钉钢板内固定治疗中青年股骨颈骨折均效果显著,动力抗旋交叉钉体积较小,对髂胫束的激惹少,适合后壁完整、移位较少的患者; 空心钉钢板占位较大,固定强度高,适合股骨颈后壁破裂或缺损、骨折移位较多的患者。
Abstract:
Objective:To investigate the efficacy of hollow nail steel plate and femoral neck system(FNS)on femoral neck fracture in young and middle-aged patients.Methods:48 patients with femoral neck fracture treated with closed reduction hollow nail steel plate and antirotation cross nail from July 2020 to June 2022 were retrospectively analyzed.Among them,26 patients with hollow nail steel plate internal fixation were taken as the hollow nail steel plate group.The FNS group consisted of 22 patients with femoral neck system.All patients were followed up for 622 months,and incision length,intraoperative blood loss,operation duration,postoperative weight bearing,hospitalization and fracture healing time of the two groups were recorded,as well as fracture reduction quality,femoral neck shortening distance and posterior tilt angle of the femoral head of the two groups were recorded.Complications such as femur head necrosis,limb contraction,fracture nonunion,hip varus deformity and chronic lateral greater trochanteric pain were observed and the incidence rate was calculated.Harris hip function score was performed before and after surgery,at 1 month,3 months and 6 months,respectively.Results:Hollow nail steel plate group had greater intraoperative blood loss,longer operation time and longer incision length compared with FNS group(P<0.05),but there was no significant difference in intraoperative fluoroscopy times and fracture healing time(P>0.05).The Harris hip function scores of the two groups were better than those before surgery(P<0.05),and the scores were similar before and after surgery(P>0.05).There was no significant difference in fracture reduction quality between the two groups(P>0.05).The length of femoral neck shortening and the posterior inclination of femoral head of hollow nail steel plate were smaller than those of FNS group(P<0.05).In the hollow nail steel plate group,there were 1 case of limb shortening,2 cases of delayed fracture healing,5 cases of chronic pain outside the greater trochanteric,and the complication rate was 30.77%.In the FNS group,limb shortening occurred in 2 cases,delayed fracture union in 2 cases,and coxal varus in 3 cases,with a complication rate of 31.81%.There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Both FNS and hollow nail steel plate internal fixation are effective on the treatment of young femoral neck fractures.FNS is small in volume and less irritating to the iliotibial band.It is suitable for patients with intact posterior wall and less displacement.The hollow nail steel plate is suitable for patients with fracture or defect of posterior wall of femoral neck and fracture displacement.

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备注/Memo

备注/Memo:
基金项目:常州市卫生与健康委员会指导项目(WZ202118)
常州市卫生健康青苗人才培养工程资助项目(CZQM2020122)
△通信作者 E-mail:wjzyyy_gsk@163.com
更新日期/Last Update: 2023-12-10