| 股骨颈系统和空心加压螺钉治疗青壮年不稳定性股骨颈骨折短期随访 |
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投稿时间：2022-12-18
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| 作者 | Author | 单位 | Address | E-Mail |
| 张峰 |
ZHANG Feng |
阜阳市人民医院骨科, 安徽 阜阳 236000 |
Department of Orthopaedics, Fuyang People's Hospital, Fuyang 236000, Anhui, China |
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| 聂宇 |
NIE Yu |
阜阳市人民医院骨科, 安徽 阜阳 236000 |
Department of Orthopaedics, Fuyang People's Hospital, Fuyang 236000, Anhui, China |
251145656@qq.com |
| 柴子豪 |
CHAI Zi-hao |
阜阳市人民医院骨科, 安徽 阜阳 236000 |
Department of Orthopaedics, Fuyang People's Hospital, Fuyang 236000, Anhui, China |
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| 樊宗庆 |
FAN Zong-qing |
阜阳市人民医院骨科, 安徽 阜阳 236000 |
Department of Orthopaedics, Fuyang People's Hospital, Fuyang 236000, Anhui, China |
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| 付廷 |
FU Ting |
阜阳市人民医院骨科, 安徽 阜阳 236000 |
Department of Orthopaedics, Fuyang People's Hospital, Fuyang 236000, Anhui, China |
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| 期刊信息：《中国骨伤》2023年，第36卷，第7期，第635-640页 |
| DOI：10.12200/j.issn.1003-0034.2023.07.008 |
| 基金项目:安徽医科大学校科研基金项目（编号：2021xkj208）；安徽省科技厅2017年重点研究与开发计划立项项目（编号：1704a0802159） |
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中文摘要:
目的：探讨股骨颈动力交叉螺钉系统（femoral neck system，FNS）与3枚空心加压螺钉（cannulate compression screw，CCS）治疗青壮年不稳定性股骨颈骨折的疗效。
方法：回顾分析2018年8月至2021年8月收治的52例青壮年不稳定性股骨颈骨折患者临床资料，根据内固定方式分为两组，25例行FNS固定，27例行闭合复位3枚CCS倒三角形分布内固定。记录并比较两组患者的手术时间、切口长度、术中出血量、住院费用、骨折复位质量；术后定期随访患者，比较两组患者骨折愈合时间、术后完全负重时间、术后并发症发生（骨不连、股骨颈短缩、股骨头坏死等）。术后6个月采用Harris评分评估髋关节功能。
结果：两组患者手术均顺利完成，FNS组患者出血量多于CCS组、切口长度大于CCS组、住院费用高于CCS组（P<0.01）。两组患者手术时间及术中复位Garden指数比较差异均无统计学意义（P>0.05）。两组患者均获得随访，时间6~32个月。FNS组骨折愈合时间少于CCS组，术后完全负重时间早于CCS组，髋关节Harris评分高于CCS组（P<0.01）。两组患者随访期间均未发生内固定断裂并发症，FNS组发生股骨头缺血性坏死4例、股骨颈短缩2例，其中3例因股骨头缺血性坏死行全髋关节置换术；CCS组发生骨不连2例、股骨头缺血性坏死9例、股骨颈短缩11例，其中5例因骨不连、股骨头缺血性坏死行全髋关节置换术。
结论：FNS具有操作简单、兼具旋转稳定和成角稳定，使患者能尽早开始功能锻炼，降低不稳定性股骨颈骨折术后并发症发生率，是治疗青壮年不稳定性股骨颈骨折的新选择。 |
| 【关键词】股骨颈系统 空心加压螺钉 股骨颈骨折 内固定 |
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| Short term follow-up of unstable femoral neck fractures in young adults treated with femoral neck system and cannulated compression screws |
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ABSTRACT
Objective To investigate the clinical efficacy of femoral neck system(FNS) and three cannulated compression screws(CCS) in the treatment of unstable femoral neck fractures in young adults.
Methods The clinical data of 52 young and middle-aged patients with unstable femoral neck fractures admitted from August 2018 to August 2021 were reviewed and analyzed. All patients were divided into two groups according to the internal fixation method, 25 cases were treated with FNS fixation, 27 cases were treated with closed reduction and 3 CCS inverted triangular distribution. The operation time, incision length, intraoperative bleeding, hospitalization expenses and fracture reduction quality of two groups were recorded and compared;The patients were followed up regularly after operation. The fracture healing time, complete weight-bearing time and postoperative complications(nonunion, femoral neck shortening, femoral head necrosis) of two groups were compared. The Harris score was used to evaluate hip function 6 months after surgery.
Results The operation was successfully completed in both groups. The patients in FNS group had more bleeding, longer incision length and higher hospitalization cost than CCS group(P<0.01). There ware no significant difference in operation time and Garden index between two groups(P>0.05). Patients in both groups were followed up for 6 to 32 months.The fracture healing time in FNS group was less than that in CCS group, the time of complete weight bearing after surgery was earlier than that in CCS group, and the hip Harris score was higher than that in CCS group (P<0.01). There were no internal fixation fracture complications in two groups during follow-up. In the FNS group, there were 4 cases of avascular necrosis of the femoral head and 2 cases of femoral neck shortening, of which 3 cases underwent total hip replacement due to avascular necrosis of the femoral head. In the CCS group, there were 2 cases of nonunion, 9 cases of avascular necrosis of the femoral head, and 11 cases of femoral neck shortening, among which 5 cases underwent total hip replacement due to nonunion and avascular necrosis of the femoral head.
Conclusion With simple operation, rotational stability and angular stability, FNS enables patients to start functional exercise as early as possible and reduces the incidence of postoperative complications of unstable femoral neck fracture. It is a new choice for the treatment of unstable femoral neck fracture in young adults. |
| KEY WORDS Femoral neck system Cannulate compression screw Femoral neck fracture Internal fixation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张峰,聂宇,柴子豪,樊宗庆,付廷.股骨颈系统和空心加压螺钉治疗青壮年不稳定性股骨颈骨折短期随访[J].中国骨伤,2023,36(7):635~640 |
| 英文格式: | ZHANG Feng,NIE Yu,CHAI Zi-hao,FAN Zong-qing,FU Ting.Short term follow-up of unstable femoral neck fractures in young adults treated with femoral neck system and cannulated compression screws[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(7):635~640 |
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