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《国际骨科学杂志》[ISSN:1673-7083/CN:31-1952/R]

期数:

2021年01期

页码:

59-64

栏目:

临床研究

出版日期:

2021-02-10

文章信息/Info

Title:

Comparative analysis of different number of cannulated screws in fixation of femoral neck fractures

作者:

罗卢华; 沈洪晖; 杨坚; 吴仕旺; 杜健; 孔菲; 顾铁军; 仇建军

201501, 上海中医药大学附属龙华医院金山分院(金山区中西医结合医院)骨科(罗卢华、沈洪晖、杨坚、吴仕旺、杜健、孔菲); 201501, 上海中医药大学附属龙华医院金山分院(金山区中西医结合医院)放射科(顾铁军); 200062, 上海中医药大学附属普陀医院骨科(仇建军)

Author(s):

LUO Luhua¹;  SHEN Honghui¹;  YANG Jian¹;  WU Shiwang¹;  DU Jian¹;  KONG Fei¹;  GU Tiejun²;  QIU Jianjun³.

Department of Orthopaedics, Jinshan Branch, Longhua Hospital, Shanghai University of Traditional Chinese Medicine¹, Shanghai 201501, China; Department of Radiology, Jinshan Branch, Longhua Hospital, Shanghai University of Traditional Chinese Me

关键词:

空心钉;  内固定;  股骨颈骨折;  疗效

Keywords:

Cannulated screws;  Fixation;  Femoral neck fractures;  Efficacy

分类号:

-

DOI:

10.3969/j.issn.1673-7083.2021.01.014

文献标识码:

-

摘要:

目的 探讨不同数量空心钉运用于股骨颈骨折内固定术的疗效。方法 回顾性分析上海中医药大学附属龙华医院金山分院2016年4月至2019年4月采用闭合复位空心钉内固定治疗的20例股骨颈骨折患者临床资料,以其中11例采用倒“品”字3枚7.3 mm空心钉内固定的患者作为对照组,以另9例采用倒“品”字3枚空心钉加1枚横向6.5 mm空心钉内固定的患者作为研究组。所有患者均进行6～12个月的随访,记录两组出血量及手术、术后负重、住院及骨折愈合时间,观察并发症如股骨头坏死、肢体短缩、骨折不愈合、髋内翻畸形发生情况并计算发生率,分别在手术前及手术后3个月、6个月进行Harris髋关节功能评分,并进行手术前后生活质量(QOL)评分。结果 研究组手术时间长于对照组,术中出血量大于对照组,但术后负重、住院及骨折愈合时间均短于对照组(P<0.05)。研究组并发症发生率为22.22%,明显低于对照组(36.36%,P<0.05)。两组术前Harris髋关节功能评分差异无统计学意义(P>0.05),但术后3个月、6个月Harris髋关节功能评分均高出术前(P<0.05),术后3个月、6个月两组Harris髋关节功能评分差异无统计学意义(P>0.05)。两组术前QOL评分差异无统计学意义(P>0.05),术后各项评分均较术前明显升高(P<0.05),但研究组术后食欲、精神、睡眠、疲乏、疼痛、日常生活评分均高于对照组(P<0.05)。结论 采用3枚空心钉加1枚横向空心钉内固定治疗股骨颈骨折效果明显,可有效保证力学稳定性,减少卧床时间,促进髋关节功能恢复,降低并发症发生率,提高生存质量。

Abstract:

Objective To compare the efficacy of femoral neck fractures fixed with different number of cannulated screws.Methods A total of 20 patients suffering femoral neck fractures treated with closed reduction and internal fixation with cannulated screws from Ap

参考文献/References

[1] 殷浩, 周恩昌, 潘政军, 等. 4枚空心钉与3枚空心钉结合支持钢板内固定治疗Pauwels Ⅲ型股骨颈骨折的有限元分析[J]. 中国组织工程研究, 2019, 23(32): 5133-5137.
[2] Makridis KG, Karachalios T, Kontogeorgakos VA, et al. The effect of osteoporotic treatment on the functional outcome, re-fracture rate, quality of life and mortality in patients with hip fractures: a prospective functional and clinical outcome study on 520 patients[J]. Injury, 2015, 46(2): 378-383.
[3] Fischer S, Vogl TJ, Marzi I, et al. Percutaneous cannulated screw fixation of sacral fractures and sacroiliac joint disruptions with CT-controlled guidewires performed by interventionalists: single center experience in treating posterior pelvic instability[J]. Eur J Radiol, 2015, 84(2): 290-294.
[4] Russell TA, Browne TD, Jacofsky M, et al. The problem of fracture fixation augmentation and description of a novel technique and implant for femoral neck stabilization[J]. Tech Orthop, 2015, 30(1): 22-27.
[5] Cicek H, Seyfettinoglu F, Kilicarslan K, et al. What should be the preferred choice of hemiarthroplasty technique in American Society of Anesthesiologists(ASA)class Ⅲ patients with femoral neck fractures? Cemented or cementless[J]. Injury, 2015, 46(8): 1567-1570.
[6] Wang D, Xiang JP, Chen XH, et al. A meta-analysis for postoperative complications in tibial plafond fracture: open reduction and internal fixation versus limited internal fixation combined with external fixator[J]. J Foot Ankle Surg, 2015, 54(4): 646-651.
[7] 刘云鹏, 刘沂. 骨与关节损伤和疾病的诊断分类及功能评定标准[M]. 北京: 清华大学出版社, 2002: 230.
[8] Li CI, Liu CS, Lin WY, et al. Glycated hemoglobin level and risk of hip fracture in older people with type 2 diabetes: a competing risk analysis of taiwan diabetes cohort study[J]. J Bone Miner Res, 2015, 30(7): 1338-1346.
[9] Mann T, Eisler T, Bodén H, et al. Larger femoral periprosthetic bone mineral density decrease following total hip arthroplasty for femoral neck fracture than for osteoarthritis: a prospective, observational cohort study[J]. J Orthop Res, 2015, 33(4): 504-512.
[10] López E, Casajús JA, Ibarz E, et al. Application of a model based on dual-energy X-ray absorptiometry and finite element simulation for predicting the probability of osteoporotic hip fractures to a sample of people over 60 years[J]. Proc Inst Mech Eng H, 2015, 229(5): 369-385.
[11] Yang Z, Liu H, Xie X, et al. Total hip arthroplasty for failed internal fixation after femoral neck fracture versus that for acute displaced femoral neck fracture: a comparative study[J]. J Arthroplasty, 2015, 30(8): 1378-1383.
[12] Inngul C, Enocson A. Postoperative periprosthetic fractures in patients with an Exeter stem due to a femoral neck fracture: cumulative incidence and surgical outcome[J]. Int Orthop, 2015, 39(9): 1683-1688.
[13] 李刚, 黄品强, 杨勇, 等. 闭合复位经皮4枚空心钉内固定治疗Pauwels Ⅲ型年轻股骨颈骨折的临床研究[J]. 医学研究杂志, 2017, 46(9): 91-95.
[14] Shih KS, Hsu CC, Hou SM, et al. Comparison of the bending performance of solid and cannulated spinal pedicle screws using finite element analyses and biomechanical tests[J]. Med Eng Phys, 2015, 37(9): 879-884.
[15] Rajani R, Wise B, Oswald T, et al. Epiphysiolysis of the femoral neck due to closed reduction of an adolescent hip dislocation with a 4-year follow-up: a case report and review of the literature[J]. J Pediatr Orthop B, 2015, 24(1): 40-45.

备注/Memo

备注/Memo:

通信作者: 仇建军 E-mail: qjj_sjtu@126.com

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更新日期/Last Update: 2021-02-10