全髋关节置换与空心螺钉内固定在股骨颈骨折中的应用效果观察

Effectiveness of Total Hip Replacement with Hollow Screw Internal Fixation in Femoral Neck Fractures

目的分析全髋关节置换与空心螺钉内固定对股骨颈骨折(FNF)患者的具体效用.方法选取2019年5月—2022年5月该院收治的76例FNF患者,按随机数字表法分成对照组与观察组,各38例.对照组采取空心螺钉内固定术,观察组采取全髋关节置换术,均观察至术后3个月.比较两组手术相关指标、髋关节功能、生活质量及并发症.结果观察组术中出血量为(238.74±15.13)mL,多于对照组的(149.35±12.28)mL,手术时间为(42.36±4.31)min,短于对照组的(90.58±6.49)min,住院时间为(10.31±1.75)d,短于对照组(15.75±2.36)d,组间差异有统计学意义(P<0.05).术后3个月,观察组的Harris髋关节功能评分(79.87±4.06)分高于对照组的(70.68±3.51)分,差异有统计学意义(P<0.05).术后3个月,观察组的生活质量综合评定问卷中心理、躯体、社会功能、物质生活状态评分分别为(79.41±3.94)分、(81.38±3.46)分、(82.37±3.95)分、(80.69±4.15)分,均高于对照组的(71.28±3.05)分、(70.69±2.97)分、(71.48±3.26)分、(72.48±3.41)分,组间差异有统计学意义(P<0.05).观察组并发症发生率为5.26%,低于对照组的21.05%,差异有统计学意义(P<0.05).结论空心螺钉内固定具有创伤小、术中出血量少等优势,但全髋关节置换术更利于FNF患者髋关节功能恢复,提高其生活质量,且并发症较少,临床应用价值更高.

Objective To analyze the specific utility of total hip replacement with hollow screw internal fixation in patients with femoral neck fracture(FNF).Methods 76 patients with FNF admitted to the hospital from May 2019 to May 2022 were selected and divided into a control group and an observation group according to the random number table method,with 38 cases each.The control group adopted hollow screw internal fixation and the observation group adopted total hip arthroplasty,and both were observed until 3 months after surgery.The operation-related indexes,hip joint function,quality of life and complications were compared between the two groups.Results The intraoperative bleeding in the observation group was(238.74±15.13)mL,more than(149.35±12.28)mL in the control group,and the operative time was(42.36±4.31)min,shorter than(90.58±6.49)min in the control group,and the hospital stay was(10.31±1.75)d,shorter than(15.75±2.36)d in the control group,the differences between the groups were statistically significant(P<0.05).At 3 months after surgery,the Harris hip function score of the observation group(79.87±4.06)points was higher than that of the control group(70.68±3.51)points,and the difference was statistically significant(P<0.05).At 3 months after surgery,the scores of psychological,physical,social function and material life status in the comprehensive assessment questionnaire of life quality of the observation group were(79.41±3.94)points,(81.38±3.46)points,(82.37±3.95)points and(80.69±4.15)points,respectively,which were higher than those of the control group(71.28±3.05)points,(70.69±2.97)points,(71.48±3.26)points,(72.48±3.41)points,and the differences between the groups were statistically significant(P<0.05).The complication rate in the observation group was 5.26%,which was lower than 21.05%in the control group,and the difference was statistically significant(P<0.05).Conclusion Internal fixation with hollow screws has the advantages of less trauma and less intraoperative bleeding,but total hip arthroplasty is more conducive to the recovery of hip function in FNF patients and improves their quality of life,and has fewer complications,so it has higher clinical application value.