[1]丛云海,夏效泳,朱治国,等.股骨颈动力交叉钉系统治疗中青年股骨颈骨折的短期疗效分析[J].中国中医骨伤科杂志,2023,31(09):58-62.[doi:10.20085/j.cnki.issn1005-0205.230911 ]
　CONG Yunhai,XIA Xiaoyong,ZHU Zhiguo,et al.The Analysis of the Short-Term Efficacy on Femoral Neck System on the Treatment of Pauwels Femoral Neck Fractures in Young and Middle-Aged Patients[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(09):58-62.[doi:10.20085/j.cnki.issn1005-0205.230911 ]
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股骨颈动力交叉钉系统治疗中青年股骨颈骨折的短期疗效分析()
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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09期
页码:
58-62
栏目:
临床报道
出版日期:
2023-09-15

文章信息/Info

Title:
The Analysis of the Short-Term Efficacy on Femoral Neck System on the Treatment of Pauwels Femoral Neck Fractures in Young and Middle-Aged Patients
文章编号:
1005-0205(2023)09-0058-05
作者:
丛云海1; 夏效泳1; 朱治国1; 王立超1; 史宗新1△
1首都医科大学良乡教学医院(北京,102400)
Author(s):
CONG Yunhai1; XIA Xiaoyong1; ZHU Zhiguo1; WANG Lichao1; SHI Zongxin1△
1Liangxiang Teaching Hospital of Capital Medical University,Beijing 102400,China.
关键词:
中青年股骨颈骨折;  内固定治疗;  动力交叉钉系统
Keywords:
femoral neck fracture in young and middle-aged patients;  internal fixation treatment;  femoral neck system
分类号:
R683.42
DOI:
10.20085/j.cnki.issn1005-0205.230911
文献标志码:
B
摘要:
目的:分析股骨颈动力交叉钉系统治疗Pauwels Ⅲ型中青年股骨颈骨折的短期临床疗效。方法:2020年1月至2021年11月采用股骨颈动力交叉钉系统(Femoral Neck System,FNS)治疗Pauwels Ⅲ型中青年股骨颈骨折40例。男23例,女17例; 年龄为49～64岁,平均为56.5岁。致伤原因:交通伤22例,高处坠落伤12例,摔伤6例。术前均行髋关节X线片和CT检查,影像学检查提示均为Pauwels Ⅲ型股骨颈骨折,骨折Garden分型:Ⅱ型8例,Ⅲ型8例,Ⅳ型24例。记录术中骨折复位质量,统计手术时间、术中出血量和骨折愈合时间,分析术后并发症、末次随访时股骨颈短缩程度以及髋关节Harris 评分。结果:40例患者术后均获得随访,随访时间为5～16个月,平均为13.2个月; 手术时间为30～110 min,平均为44.5 min; 术中出血量为45～200 mL,平均为80.6 mL。术中骨折复位质量Ⅰ级37例,Ⅱ级3例。38例患者术后13～24周骨折愈合,平均为17.4周,之后开始完全负重行走; 1例患者术后6个月复查时出现股骨头坏死; 1例患者术后5个月出现抗旋转钉的切出,骨折未愈合。所有患者术后无切口感染等短期并发症,其余38例患者术后无内固定物松动、股骨头塌陷等并发症。末次随访时股骨颈短缩程度1级30例,2级9例,3级1例。末次随访时采用 Harris 评分评价髋关节功能:优31例,良7例,差2例,优良率为95.0%。结论:股骨颈动力交叉钉系统内固定治疗Pauwels Ⅲ型中青年股骨颈骨折能够提供足够的支撑强度,复位固定效果确切,能够满足术后康复的需要,临床效果满意。
Abstract:
Objective:To analyze the short-term clinical efficacy of femoral neck system in the treatment of Pauwels type Ⅲ femoral neck fractures in young and middle-aged patients.Methods:From January 2020 to November 2021,the femoral neck system(FNS)was used to treat 40 young and middle-aged patients with Pauwels type Ⅲ femoral neck fractures.There were 23 males and 17 females.The age ranked from 49 to 64 years old with 56.5 years old on average.The causes of injury were traffic accidents in 22 cases,falling from height in 12 cases,and falling in 6 cases.Preoperative hip X-ray and CT examination showed Pauwels type Ⅲ femoral neck fractures in all patients.According to Garden classification,8 cases were rated as type Ⅱ,8 cases as type Ⅲ,and 24 cases as type Ⅳ.The quality of intraoperative fracture reduction,the operation time,intraoperative blood loss,and fracture healing time were recorded.The postoperative complications,femoral neck shortening and hip Harris score at the last follow-up were analyzed.Results:All patients were followed up for 516 months,with 13.2 months on average.The operation time was 30110 min,with 44.5 min on average.The intraoperative blood loss was 45200 mL,with 80.6 mL on average.The quality of fracture reduction was gradeⅠin 37 cases and grade Ⅱ in 3 cases.The fractures of 38 patients healed at 1324 weeks,with 17.4 weeks on average after operation,and they began to walk with full weight-bearing.One patient had osteonecrosis of the femoral head at 6 months after operation.The anti-rotation nail was cut out in 1 patient at 5 months after operation,and the fracture did not heal.All patients had no short-term complications such as incision infection after operation,and the other 38 patients had no complications such as internal fixation loosening and femoral head collapse after operation.At last follow-up,the degree of femoral neck shortening was grade 1 in 30 cases,grade 2 in 9 cases,and grade 3 in 1 case.At the last follow-up,according to Harris score,31 cases were excellent,7 cases were good,and 2 cases were poor,with an excellent and good rate of 95.0%.Conclusion:Femoral neck system internal fixation on the treatment of Pauwels type Ⅲ femoral neck fractures in young and middle-aged patients can provide sufficient support strength,accurate reduction and fixation,and meet the needs of postoperative rehabilitation and can achieve a satisfactory clinical efficacy.

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备注/Memo

备注/Memo:
△通信作者 E-mail:shizongxin_or@163.com
更新日期/Last Update: 2023-09-01