[1]朱春晖 刘刚 陈伟**.股骨颈动力交叉钉系统与空心加压螺钉治疗中青年Pauwels Ⅲ型股骨颈骨折的疗效比较[J].中国微创外科杂志,2024,01(9):610-616.
　Zhu Chunhui,Liu Gang,Chen Wei..Comparison of Femoral Neck System and Cannulated Compression Screw in the Treatment of Pauwels Type Ⅲ Femoral Neck Fractures in Young and Middleaged Patients[J].Chinese Journal of Minimally Invasive Surgery,2024,01(9):610-616.
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股骨颈动力交叉钉系统与空心加压螺钉治疗中青年Pauwels Ⅲ型股骨颈骨折的疗效比较()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2024年9期
页码:
610-616
栏目:
临床研究
出版日期:
2024-09-25

文章信息/Info

Title:
Comparison of Femoral Neck System and Cannulated Compression Screw in the Treatment of Pauwels Type Ⅲ Femoral Neck Fractures in Young and Middleaged Patients
作者:
朱春晖 刘刚 陈伟**
(南京医科大学附属常州第二人民医院创伤中心，常州213003)
Author(s):
Zhu Chunhui;  Liu Gang;  Chen Wei.
Trauma Center, Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou 213003, China
关键词:
股骨颈骨折; 骨折内固定术; 股骨颈动力交叉钉系统; 空心加压螺钉
Keywords:
Femoral neck fracture; Fracture internal fixation; Femoral neck system; Cannulated compression screw
文献标志码:
A
摘要:
目的比较股骨颈动力交叉钉系统(femoral neck system，FNS)与空心加压螺钉(cannulated compression screws，CCS)治疗中青年Pauwels Ⅲ型股骨颈骨折的疗效。方法回顾性分析2019年1月~2022年8月103例中青年Pauwels Ⅲ型股骨颈骨折的临床资料，根据手术方式不同分为股骨颈动力交叉钉系统FNS组(n=54)和空心加压螺钉CCS组(n=49)。比较2组术中出血量、手术时间、术后骨折复位质量(Garden对位指数)、骨折愈合时间、术后下地负重时间、术后并发症、股骨颈短缩长度、颈干角变化(术后即刻与末次随访时颈干角差值)和髋关节 Harris 评分。结果FNS组手术时间［(46.7±123)min vs. (69.7±14.1)min，t=-8.840，P=0.000］、术后下地负重时间［(115±27)周vs (157±32)周，t=-7124，P=0000］、骨折愈合时间［(37±08)月 vs (43±09)月，t=-3625, P=0001］、并发症发生率［18%(1/54) vs 143%(7/49)， χ2=3944, P=0047］均显著短于/低于CCS组。2组术中出血量、骨折复位质量、随访时间及颈干角变化无统计学差异(P＞005)。髋关节Harris评分术后3个月［(845±39)分 vs(827±44)分，t=2212, P=0029］、术后6个月［(914±44)分 vs(897±40)分，t=2119，P=0037］和术后1年［(960±28)分 vs(948±31)分，t=2029，P=0045］均显著高于CCS组。末次随访FNS 组股骨颈短缩长度［(46±28)mm vs(59±33)mm，t=-2165，P=0033］显著小于CCS组。结论与CCS比较，FNS内固定治疗中青年Pauwels Ⅲ型股骨颈骨折疗效显著，骨折愈合时间短，可有效改善髋关节功能，促进髋关节活动康复，降低术后并发症发生率。
Abstract:
ObjectiveTo compare the clinical efficacy of the femoral neck system (FNS) and cannulated compression screw (CCS) in the treatment of Pauwels type Ⅲ femoral neck fractures in young and middleaged patients.MethodsWe retrospectively studied 103 clinical cases of young and middleaged patients with Pauwels type Ⅲ femoral neck fractures who were treated with internal fixation surgery between January 2019 and August 2022. According to different surgical methods, they were divided into FNS group (54 cases) and CCS group (49 cases). The intraoperative bleeding volume, operation time, quality of fracture reduction (Garden alignment index), bone healing time, postoperative weightbearing time, postoperative complications,shortening length of femoral neck, change of femoral neckshaft angle (difference between immediately after operation and at the last followup), and Harris hip score were compared between the two groups.ResultsCompared to the CCS group, the FNS group had significantly shorter operation time ［(46.7±12.3) min vs. (69.7±14.1) min, t=-8.840, P=0.000］, reduced postoperative weightbearing time ［(11.5±2.7) weeks vs. (15.7±3.2) weeks, t=-7.124, P=0.000］, shorter fracture healing time ［(3.7±0.8) months vs. (4.3±0.9) months, t=-3.625, P=0.001］, and significantly lower incidence of complications ［1.8%(1/54) vs. 143%(7/49), χ2=3.944, P=0.047］. The FNS group also demonstrated significantly higher Harris hip scores at 3 months ［(84.5±39) points vs. (82.7±4.4) points, t=2.212, P=0.029］, 6 months ［(91.4±4.4) points vs. (89.7±4.0) points, t=2.119, P=0037］, and 1 year ［(96.0±2.8) points vs. (94.8±3.1) points, t=2.029, P=0.045］ postoperatively compared to the CCS group. At the last followup, the FNS group showed significantly shorter femoral neck shortening ［(4.6±2.8) mm vs. (5.9±3.3) mm, t=2.165, P=0.033］ compared to the CCS group.ConclusionsCompared to CCS, FNS shows better efficacy in the internal fixation of Pauwels type Ⅲ femoral neck fractures with a shorter bone healing time. With the application of FNS, the rehabilitation of the hip joint is promoted, and the hip joint function is effectively improved, as well as the incidence of postoperative complications is reduced.

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备注/Memo

备注/Memo:
基金项目：常州市科技计划资助（CJ20220072、CJ20230070）；常州市卫生与健康委员会青年人才科技项目(QN202118)；常州市卫生健康青苗人才工程（CZQM2022009）；常州市卫生健康人才国外研修资助项目（GW2023021）**通讯作者，Email：13641502368@163.com
更新日期/Last Update: 2024-12-17