股骨颈骨折内固定术后早期限量负重对患者功能恢复的回顾性研究

A Retrospective Study of Limited Weight-bearing on Patients'Functional Recovery after Internal Fixation of Femoral Neck Fractures

目的分析股骨颈骨折内固定术后早期限量负重对患者功能恢复的影响。方法回顾性分析2013年1月—2014年12月厦门大学附属福州第二医院收治的GardenⅢ-Ⅳ型股骨颈骨折患者138例的临床资料,均接受经皮空心钉内固定手术,根据术后负重时间分为早期负重组(23例)和晚期负重组(115例),随访6个月。比较两组患者临床指标及并发症,比较两组患者手术前后髋关节功能及疼痛情况。结果早期负重组患者住院时间(5.26±1.22)d、骨折愈合时间为(11.26±3.02)周,短于晚期负重组患者(6.96±1.02)d,(13.20±2.05)周,差异有统计学意义(t=7.055,3.799,P<0.05);和术前相比,两组术后1~6个月,髋关节功能评分趋势,呈现为逐渐升高,且术后早期负重组1个月(56.23±5.14)分、3个月(78.63±6.15)分高于晚期负重组的(47.62±5.12)分、(75.25±4.18)分,差异有统计学意义(t=7.358,3.247,P<0.05);和术前相比,术后1~6个月,两组VAS评分趋势,逐渐降低,差异有统计学意义(P<0.05),但组间不同时间点相比较,差异无统计学意义(P>0.05);两组患者并发症总发生率比较,差异无统计学意义(P>0.05)。结论股骨颈骨折空心钉内固定术后患者早期限量负重训练可在一定程度上促进患者骨折愈合,提升患者早期关节功能,缩短患者住院时间。

Objective To analyze the effect of limited weight-bearing on patients'functional recovery after internal fixation of femoral neck fractures.Methods A retrospective analysis of the clinical data of 138 patients with GardenⅢ-Ⅳfemoral neck fractures admitted to Fuzhou Second Hospital Affiliated to Xiamen University from January 2013 to December 2014.All patients underwent percutaneous cannulated nail internal fixation.The weight-bearing time was divided into early negative restructuring(23 cases)and late negative restructuring(115 cases),followed up for 6 months.The clinical indicators and complications of the two groups of patients were compared,and the hip joint function and pain before and after the operation were compared between the two groups.Results The hospitalization time and fracture healing time of early negative recombination patients were(5.26±1.22)d and(11.26±3.02)weeks,which were shorter than those of late negative recombination patients(6.96±1.02)d and(13.20±2.05)weeks,the difference was statistically significant(t=7.055,3.799,P<0.05);compared with before operation,the hip function score of the two groups increased gradually from 1 month to 6 months after operation,and the scores of early negative recombination at 1 month(56.23±5.14)points and 3 months(78.63±6.15)points were higher than those of late negative recombination(47.62±5.12)points and(75.25±4.18)points,the difference was statistically significant(t=7.358,3.247,P<0.05);compared with before operation,the VAS score of the two groups decreased gradually from 1 month to 6 months after operation,the difference was statistically significant(P<0.05),but there was no significant difference between the two groups at different time points(P>0.05);There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Early limited weight-bearing training for patients after femoral neck fracture internal fixation with hollow nails can promote fracture healing to a certain extent,improve early joint function of patients,and shorten the patient's hospital stay.