[1]刘英科,陈勤,陈柯△,等.股骨颈动力交叉钉系统治疗中青年垂直不稳定型股骨颈骨折32例[J].中国中医骨伤科杂志,2023,31(12):70-75+79.[doi:10.20085/j.cnki.issn1005-0205.231215]
　LIU Yingke,CHEN Qin,CHEN Ke,et al.Femoral Neck System in the Treatment of 32 Cases of Young and Middle-Aged Vertically Unstable Femoral Neck Fracture[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(12):70-75+79.[doi:10.20085/j.cnki.issn1005-0205.231215]
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股骨颈动力交叉钉系统治疗中青年垂直不稳定型股骨颈骨折32例()
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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:
70-75+79
栏目:
临床报道
出版日期:
2023-12-15

文章信息/Info

Title:
Femoral Neck System in the Treatment of 32 Cases of Young and Middle-Aged Vertically Unstable Femoral Neck Fracture
文章编号:
1005-0205(2023)12-0070-06
作者:
刘英科1; 陈勤2; 陈柯2△; 马文龙2; 田可为2; 范克杰2; 毛雯正1; 田燃2; 邝孝坤1
1河南中医药大学(郑州,450046); 2河南省洛阳正骨医院(河南省骨科医院)髋关节外科
Author(s):
LIU Yingke1; CHEN Qin2; CHEN Ke2△; MA Wenlong2; TIAN Kewei2; FAN Kejie2; MAO Wenzheng1; TIAN Ran2; KUANG Xiaokun1
1Henan University of Chinese Medicine,Zhengzhou 450046,China; 2Hip and Joint Surgery Department,Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Luoyang 471002,Henan China.
关键词:
垂直不稳定型股骨颈骨折;  股骨颈动力交叉钉系统;  内固定
Keywords:
vertically unstable femoral neck fracture;  femoral neck system;  internal fixation
分类号:
R683.42
DOI:
10.20085/j.cnki.issn1005-0205.231215
文献标志码:
B
摘要:
目的:观察股骨颈动力交叉钉系统(Femoral Neck System,FNS)内固定治疗中青年垂直不稳定型股骨颈骨折的近期疗效,并探讨其术中经验及注意事项。方法:2020年1月至2021年12月,采用股骨颈动力交叉钉系统内固定治疗中青年垂直不稳定型股骨颈骨折32例,所有患者均为单侧、新鲜闭合性骨折,随访观察早中期疗效及并发症情况。结果:手术时间为40～130 min,平均为(77.8±21.7)min; 术中出血量为50～120 mL,平均为(70.6±19.9)mL; 切口长度为3～10 cm,平均为(4.2±0.9)cm; 1例患者复位不佳,股骨颈短缩,其余患者均达到解剖复位或良好复位,术后切口均一期愈合; 所有患者均获随访,随访时间为15～30个月,平均为(21.5±3.2)个月; 骨折均临床愈合,愈合时间为14～24周,平均为(17.8±1.9)周; 术后早期发生下肢静脉血栓2例,予以对症处理后均治愈; 术后中期发生股骨头坏死2例,ARCO分期为Ⅱ期,后行髓芯减压及植骨术,术后继续用中医药治疗结合限制性负重的保髋方法进行治疗; 末次随访股骨颈短缩发生率为28.1%(9/32),除1例患者股骨颈严重短缩并发生不完全愈合,后期继续密切观察,其余患者未出现患髋功能障碍; 末次随访髋关节功能评定采用Harris评分标准,优20例,良9例,可3例,优良率为90.6%。结论:采用股骨颈动力交叉钉系统内固定治疗中青年垂直不稳定型股骨颈骨折,创伤小,骨折愈合率高,有利于患肢功能的恢复,值得临床推广应用。
Abstract:
Objective:To observe the short-term efficacy of femoral neck system(FNS)internal fixation in the treatment of vertically unstable femoral neck fracture in young and middle-aged patients,and to explore its intraoperative experience and precautions.Methods:32 young and middle-aged patients with vertically unstable femoral neck fractures were treated with FNS internal fixation from January 2020 to December 2021,all patients were unilateral and fresh closed fractures,the early and mid-term efficacy and complications were followed up.Results:The operation time was 40130 min,with an average of(77.8±21.7)min.The intraoperative blood loss was 50120 mL,with an average of(70.6±19.9)mL.The length of incision was 310 cm,with an average of(4.2±0.9)cm.One patient had poor reduction and femoral neck shortening,and the remaining patients achieved anatomical reduction or good reduction,postoperative incisions healed in the first stage.All patients were followed up for 1530 months,with an average of(21.5±3.2)months.All fractures were clinically healed.The healing time was 1424 weeks,with an average of(17.8±1.9)weeks.Early postoperative lower extremity venous thrombosis occurred in 2 cases,which were cured after symptomatic treatment.There were 2 cases of femoral head necrosis in the middle stage after operation,ARCO stage Ⅱ,followed by core decompression and bone grafting,after operation,the treatment of traditional Chinese medicine combined with restrictive weight-bearing hip preservation was continued.The incidence of femoral neck shortening at the last follow-up was 28.1%(9/32),except for 1 patient with severe femoral neck shortening and incomplete healing,who continued to be closely observed in the later period,the remaining patients did not have hip dysfunction.Harris hip score was used to evaluate the hip function at the last follow-up.The results were excellent in 20 cases,good in 9 cases,fair in 3 cases,with the excellent and good rate was 90.6%.Conclusion:The use of FNS internal fixation for the treatment of vertically unstable femoral neck fracture in young and middle-aged people has small trauma and high fracture healing rate,which is conducive to the recovery of limb function and is worthy of clinical application.

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备注/Memo

备注/Memo:
基金项目:河南省医学科技攻关计划联合共建项目(LHGJ20230483)
河南省中医药科学研究专项课题(2021-ZY2238,20-21ZY2253,2019ZY2086)
洛阳市核心技术攻关类公益专项课题(2302053Y)
△通信作者 E-mail:115946827@qq.com
更新日期/Last Update: 2023-12-10