本文選題：股骨頸骨折　切入點：內(nèi)固定　出處：《中國修復(fù)重建外科雜志》2017年01期

【摘要】：目的探討應(yīng)用多軸鎖定鋼板內(nèi)固定治療中老年股骨頸骨折的可行性及近期療效。方法回顧性分析2013年9月—2015年6月采用多軸鎖定鋼板內(nèi)固定治療的13例股骨頸骨折患者臨床資料(A組),并與同期采用3枚倒"品"字形平行滑動加壓空心螺釘內(nèi)固定治療的13例股骨頸骨折患者(B組)進(jìn)行比較。兩組患者性別、年齡、側(cè)別、致傷原因、Garden分型、骨折部位分型、Pauwels角分型、Singh指數(shù)、受傷至手術(shù)時間、合并癥等一般資料比較差異無統(tǒng)計學(xué)意義(P0.05),具有可比性。比較兩組患者術(shù)后1年頸短縮發(fā)生情況,末次隨訪時記錄骨折不愈合、股骨頭缺血性壞死發(fā)生率,并行髖關(guān)節(jié)Harris評分。結(jié)果兩組患者均獲隨訪,A、B組隨訪時間分別為(19.23±3.98)、(18.00±3.61)個月,差異無統(tǒng)計學(xué)意義(t=2.063,P=0.417)。隨訪期間A組未出現(xiàn)股骨頭缺血性壞死;B組有1例發(fā)生股骨頭缺血性壞死,二期行股骨頭置換治療;兩組股骨頭缺血性壞死發(fā)生率比較差異無統(tǒng)計學(xué)意義(χ2=0.000,P=1.000)。其余患者骨折均骨性愈合。末次隨訪時A組髖關(guān)節(jié)Harris評分為(85.23±2.95)分,顯著高于B組的(81.92±3.64)分(t=2.064,P=0.018)。兩組患者均未發(fā)生感染及內(nèi)固定物切出等并發(fā)癥。A組1例術(shù)后1個月出現(xiàn)大腿外側(cè)酸痛,術(shù)后3個月基本緩解。術(shù)后1年A組均未發(fā)生股骨頸短縮,B組發(fā)生Ⅰ度短縮3例、Ⅱ度短縮2例、Ⅲ度短縮8例,兩組比較差異有統(tǒng)計學(xué)意義(Z= 4.714,P=0.000)。結(jié)論多軸鎖定鋼板內(nèi)固定治療中老年股骨頸骨折相較于傳統(tǒng)空心螺釘固定不顯著增加股骨頭壞死風(fēng)險,在預(yù)防術(shù)后股骨頸短縮及改善功能方面有明顯優(yōu)勢。
[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 鹵3.98% (18.00 鹵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 鹵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 鹵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，

本文編號：1678379