2种中空加压螺丝钉治疗股骨颈骨折的疗效比较

Comparison between two types of compression hollow screws in the treatment of femoral neck fractures

目的比较2种中空加压螺丝钉治疗股骨颈骨折的临床疗效。方法回顾性分析1996年2月-2004年9月我院应用2种中空加压螺丝钉治疗股骨颈骨折87例的临床资料，其中双头中空加压螺丝钉46例（A组），AO纯钛中空加压螺丝钉41例（B组）。结果2组手术时间无统计学差异（t=1．193，P=0．236），但B组手术出血量及骨折愈合时间明显少于A组（t=5．147，P=0．000；t=5．472，P=0．000）。87例随访3个月一8年，平均4.2年，接评分标准，A组优34例，良8例，可1例，差3例，优良率81．9％（41／46）；B组优37例，良2例，可2例，差0例，优良率95．1％（39／41），2组疗效优良率无统计学差异（x^2=0．398，P=0．528）。B组未发现股骨头坏死及骨折不愈合。结论2种中空加压螺丝钉治疗股骨颈骨折均具有操作简单、微创、手术时间短、固定牢固可靠、骨折愈合率高等优点，均是治疗股骨颈骨折的理想方法。其中AO纯钛中空加压螺丝钉在减少出血量、缩短骨折愈合时间及降低股骨头缺血坏死率等方面优势明显。

Objective To compare clinical curative effects of two types of compression hollow screws in the treatment of femoral neck fractures. Methods A retrospective analysis was carried out on clinical records of 87 cases of femoral neck fracture from February 1996 to September 2004 treated with two types of compression hollow screws, that is, double - headed compression hollow screws （46 cases, Group A） and AO titanium compression hollow screws （41 cases, Group B）. Results A follow up was conducted for 3 months - 8 years （ mean, 4.2 years）. No statistically significant differences were observed between the two groups. The intraoperative blood loss was significantly less and the time to bone union was significantly shorter in the Group B than in the Group A （t = 5. 147 ,P = 0. 000 ;t = 5. 472, P = 0. 000 ）, The surgical outcomes were classified as ＂excellent＂ in 34 cases, ＂ good＂ in 8, ＂fair＂ in l , and ＂poor＂ in 3 in the Group A, while ＂excellent＂ in 37 cases, ＂good＂ in 2, ＂fair＂ in 2, and ＂poor＂ in no cases in the Group B, without statistically significant differences between the two groups in the rate of ＂good＂ or ＂excellent＂ results （89. 1% vs 95.1% , X^2 = 0. 398, P = 0. 528）. No femoral head necrosis or non - union was found in the Group B. Conclusions Both of two types of compression hollow screws have showed advantages of simplicity of performance, minimal invasion, short operative time, reliable fixation, and high success rate, being an ideal option for femoral neck fractures.