多轴锁定钢板内固定治疗中老年股骨颈骨折的近期疗效观察

发布时间：2018-03-28 22:30

  本文选题：股骨颈骨折　切入点：内固定　出处：《中国修复重建外科杂志》2017年01期

【摘要】：目的探讨应用多轴锁定钢板内固定治疗中老年股骨颈骨折的可行性及近期疗效。方法回顾性分析2013年9月—2015年6月采用多轴锁定钢板内固定治疗的13例股骨颈骨折患者临床资料(A组),并与同期采用3枚倒"品"字形平行滑动加压空心螺钉内固定治疗的13例股骨颈骨折患者(B组)进行比较。两组患者性别、年龄、侧别、致伤原因、Garden分型、骨折部位分型、Pauwels角分型、Singh指数、受伤至手术时间、合并症等一般资料比较差异无统计学意义(P0.05),具有可比性。比较两组患者术后1年颈短缩发生情况,末次随访时记录骨折不愈合、股骨头缺血性坏死发生率,并行髋关节Harris评分。结果两组患者均获随访,A、B组随访时间分别为(19.23±3.98)、(18.00±3.61)个月,差异无统计学意义(t=2.063,P=0.417)。随访期间A组未出现股骨头缺血性坏死;B组有1例发生股骨头缺血性坏死,二期行股骨头置换治疗;两组股骨头缺血性坏死发生率比较差异无统计学意义(χ2=0.000,P=1.000)。其余患者骨折均骨性愈合。末次随访时A组髋关节Harris评分为(85.23±2.95)分,显著高于B组的(81.92±3.64)分(t=2.064,P=0.018)。两组患者均未发生感染及内固定物切出等并发症。A组1例术后1个月出现大腿外侧酸痛,术后3个月基本缓解。术后1年A组均未发生股骨颈短缩,B组发生Ⅰ度短缩3例、Ⅱ度短缩2例、Ⅲ度短缩8例,两组比较差异有统计学意义(Z= 4.714,P=0.000)。结论多轴锁定钢板内固定治疗中老年股骨颈骨折相较于传统空心螺钉固定不显著增加股骨头坏死风险,在预防术后股骨颈短缩及改善功能方面有明显优势。
[Abstract]:Objective to investigate the feasibility and short-term effect of multiaxial locking plate internal fixation in the treatment of femoral neck fracture in middle-aged and elderly patients. Methods 13 cases of femoral neck fractures treated with multiaxial locking plate from September 2013 to June 2015 were retrospectively analyzed. The clinical data of group A were compared with that of group B (13 patients with femoral neck fracture treated with 3 inverted "Pin" parallel sliding compression hollow screws). Age, side, cause of injury, Garden type, fracture site type, Pauwels angle type, Singh index, time from injury to operation, There was no significant difference in general data, such as complications, between the two groups (P 0.05, P 0.05). The incidence of short neck contraction at one year after operation was compared between the two groups, and the incidence of nonunion and avascular necrosis of the femoral head was recorded at the last follow-up. Results the follow-up time of group B was 19.23 卤3.98% (18.00 卤3.61) months, and there was no significant difference between the two groups. During the follow-up period, there was no ischemic necrosis of femoral head in group A and group B had no ischemic necrosis of femoral head. There was no significant difference in the incidence of avascular necrosis of the femoral head between the two groups (蠂 2 / 0. 000 P < 1. 000). Bone union was found in all the other patients. The Harris score of hip joint in group A was 85.23 卤2. 95 at the last follow-up, and there was no significant difference between the two groups in the incidence of avascular necrosis of the femoral head (蠂 2 / 0. 000). It was significantly higher than that in group B (81.92 卤3.64). There were no complications such as infection and excision of internal fixator in both groups. One case in group A had lateral thigh pain 1 month after operation. 3 months after operation, 3 cases of 鈪，

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