| 外固定架固定股骨颈骨折两种不同穿针布局方式的临床疗效比较 |
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Received:October 20, 2020
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| 作者 | Author | 单位 | Unit | E-Mail |
| 张东辉 |
ZHANG Dong-hui |
平泉市中医院外一科, 河北平泉 067500 |
The First Department of Surgery, Pingquan Traditional Chinese Medicine Hospital, Pingquan 067500, Hebei, China |
zhangdh61@126.com |
| 张扬 |
ZHANG Yang |
河北医科大学第二医院教务处, 河北石家庄 050000 |
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| 刘丽莹 |
LIU Li-ying |
平泉市中医院外一科, 河北平泉 067500 |
The First Department of Surgery, Pingquan Traditional Chinese Medicine Hospital, Pingquan 067500, Hebei, China |
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| 王金星 |
WANG Jin-xing |
平泉市中医院外一科, 河北平泉 067500 |
The First Department of Surgery, Pingquan Traditional Chinese Medicine Hospital, Pingquan 067500, Hebei, China |
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| 胡系庆 |
HU Xi-qing |
平泉市中医院外一科, 河北平泉 067500 |
The First Department of Surgery, Pingquan Traditional Chinese Medicine Hospital, Pingquan 067500, Hebei, China |
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| 赵国生 |
ZHAO Guo-sheng |
平泉市中医院外一科, 河北平泉 067500 |
The First Department of Surgery, Pingquan Traditional Chinese Medicine Hospital, Pingquan 067500, Hebei, China |
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| 吴晓虎 |
WU Xiao-hu |
平泉市中医院外一科, 河北平泉 067500 |
The First Department of Surgery, Pingquan Traditional Chinese Medicine Hospital, Pingquan 067500, Hebei, China |
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| 蒋鸿儒 |
JIANG Hong-ru |
平泉市中医院外一科, 河北平泉 067500 |
The First Department of Surgery, Pingquan Traditional Chinese Medicine Hospital, Pingquan 067500, Hebei, China |
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| 期刊信息：《中国骨伤》2021年34卷，第3期，第208-214页 |
| DOI：10.12200/j.issn.1003-0034.2021.03.004 |
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目的：分析外固定架固定治疗股骨颈骨折两种不同穿针布局方式的临床疗效。
方法：自2000年4月至2018年4月应用闭合复位经皮穿针外固定架固定治疗股骨颈骨折140例，随访1年以上121例，其中采用传统组治疗31例，男12例，女19例，年龄45~74（65.4±8.4）岁；改良组治疗90例，男39例，女51例，年龄12~75（64.5±7.8）岁。传统组第1根针打在股骨距上，第2、3根针打在张力线下，3根针在侧位相上不在一条线上；改良组第1根针偏后钻入股骨外侧皮质斜向贯穿股骨距部骨折远近端，另2根针分别偏前、偏上钻入股骨颈内侧皮质和股骨距内，3根针以股骨距为中心呈三角形排列。观察比较两组患者的手术时间、住院时间、术后下地时间、股骨颈短缩率、骨折愈合时间、骨折愈合率和股骨头坏死率，术后1年采用Harris评分评定髋关节功能。
结果：121例患者获得随访，传统组术后随访时间为13~45（30.5±11.4）个月；改良组术后随访时间为14~120（34.5±12.5）个月。两组患者手术时间、住院时间、股骨头坏死率比较差异无统计学意义（P>0.05）。两组术后下地时间、股骨颈短缩率、骨折愈合时间、骨折愈合率、术后1年患髋Harris功能评分比较差异有统计学意义（P<0.05）。
结论：改良组顺应并符合股骨近端解剖和生物力学特点，与传统组比较固定更加可靠，具有股骨颈短缩率低，骨折愈合时间短，骨折愈合率高，髋关节Harris功能评分高等优势。 |
| [关键词]:股骨颈骨折 骨固定钢丝 外固定器 |
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| Comparison of clinical efficacy of two different pin arrangements for external fixation of femoral neck fracture |
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Abstract:
Objective: To retrospectively analyze the clinical efficacy of external fixation in the treatment of femoral neck fracture with two different pin layout.
Methods: From April 2000 to April 2018,140 cases of femoral neck fracture were treated with closed reduction and percutaneous pin external fixation,among them 121 cases were followed up for more than 1 year,including 31 cases in traditional group,12 males and 19 females,aged 45 to 74(65.4±8.4) years;90 cases in modified group,39 males and 51 females,aged 12 to 75(64.5±7.8) years. In traditional group,the first needle was put on the femoral talus,the second and third needles were put under the tension line,and the three needles were not on the same line in the lateral phase; in modified group,the first needle was drilled into the lateral cortex of the femur,obliquely penetrating the distal and proximal end of the femoral talus fracture,and the other two needles were drilled into the medial cortex of the femoral neck and the femoral talus,respectively. The operation time,hospital stay,postoperative ambulation time,femoral neck shortening rate,fracture healing time,fracture healing rate and femoral head necrosis rate of the two groups were observed and compared. Harris hip function score was used one year after operation.
Results: These 121 patients were followed up,the follow-up time of traditional group was 13 to 45(30.5±11.4) months;the follow-up time of modified group was 14 to 120(34.5±12.5) months. There was no significant difference in operation time,hospital stay and femoral head necrosis rate between two groups(P>0.05). There were significant differences between two groups in the time of going to the ground,shortening rate of femoral neck,fracture healing time,fracture healing rate and Harris functional score of the hip 1 year after operation(P<0.05).
Conclusion: Compared with the traditional group,the modified group has the advantages of lower femoral neck shortening rate,shorter fracture healing time,higher fracture healing rate and higher Harris hip function score. |
| KEYWORDS:Femoral neck fractures Bone wires External fixators |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张东辉,张扬,刘丽莹,王金星,胡系庆,赵国生,吴晓虎,蒋鸿儒.外固定架固定股骨颈骨折两种不同穿针布局方式的临床疗效比较[J].中国骨伤,2021,34(3):208~214 |
| 英文格式: | ZHANG Dong-hui,ZHANG Yang,LIU Li-ying,WANG Jin-xing,HU Xi-qing,ZHAO Guo-sheng,WU Xiao-hu,JIANG Hong-ru.Comparison of clinical efficacy of two different pin arrangements for external fixation of femoral neck fracture[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(3):208~214 |
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