摘要
目的:分别应用三针锁针加压器外固定和空心拉力钉内固定疗法治疗股骨颈骨折,探讨股骨颈骨折最佳治疗方法。方法:应用三针锁针加压器外固定治疗股骨颈骨折63例,其中男24例,女39例;年龄55~89岁,平均(64.5±3.2)岁;GardenⅠ型2例,Ⅱ型15例,Ⅲ型38例,Ⅳ型8例。应用空心拉力钉内固定治疗63例,其中男29例,女34例;年龄45~76岁,平均(62.2±2.9)岁;GardenⅠ型4例,Ⅱ型24例,Ⅲ型28例,Ⅳ型7例。对其疗效进行分析。结果:126例除2例死亡外均得到随访。115例愈合,其中10例股骨头坏死。外固定组愈合58例,股骨头坏死4例,死亡1例;内固定组愈合57例,股骨头坏死6例,死亡1例。根据Harris功能评定标准评价疗效,外固定组62例中优24例,良26例,可8例,差4例,优良率80.65%;内固定组62例中优23例,良27例,可6例,差6例,优良率80.65%。Harris评分:外固定组平均(80.40±1.21)分,内固定组平均(79.14±1.47)分,两组Harris评分比较差异无统计学意义(P〉0.05)。结论:采用内外固定治疗股骨颈骨折疗效无明显差异,但外固定创伤小、费用低、可早期离床;而采用拉力钉内固定器医疗成本高,卧病时间相对较长,且需二次手术取内固定钉。
Objective:To compare therapeutic effects between external fixation apparatus and cannulated lag screws internal fixation for the treatment of femoral neck fractures,so as to find better method for treating it.Methods:Among 63 patients treated with external fixation of three locked pin compressive apparatus,24 patients were male and 39 patients were female,ranging in age from 55 to 89 years,with an average of 64.5±3.2 years.According to Garden classification,Type Ⅰ fracture occurred in 2 patients,Type Ⅱ in 15 patients,Type Ⅲ in 38 patients and Type Ⅳ in 8 patients.In the internal fixation group with cannulated lag screws,there were also 63 patients(29 males and 34 females,ranging in age from 45 to 76 years,with an average of 62.2±2.9 years.According to Garden classification,Type Ⅰ fracture occurred in 4 patients,Type Ⅱ in 24 patients,Type Ⅲ in 28 patients and Type Ⅳ in 7 patients.The therapeutic effects of the two groups were compared.Results:One hundred and twenty-four patients were followed up and 2 patients were dead.During the follow-up period,115 patients were healed and 10 patients had femoral head necrosis.In external fixation group,58 patients were healed,4 patients had femoral head necrosis and 1 patient was dead;while in internal fixation group,57 patients were healed,6 patients had femoral head necrosis and 1 patient was dead.According to Harris functional evaluation criteria,in the external fixation group 24 patients obtained excellent results,26 good,8 fair,and 4 bad,the excellent and good rate was 80.65%;in the internal fixation group,above numbers were 23,27,6,6 and 80.65% respectively.The results of Harrsi score:the average score of external fixation group was 80.40±1.21 and the internal fixation group was 79.14±1.47.The average score of the groups had no statistical differences(P〉0.05).Conclusion:The therapeutic effects of internal and external fixation method for the treatment of femoral neck fractures has no obvious differences,but the external fixation posses advantages such as minimal wound,lower cost and early leaving the bed and moving,and the internal fixation has expensive cost,long time in bed and secondary surgery of taking out internal fixation pins.
出处
《中国骨伤》
CAS
2007年第12期821-822,共2页
China Journal of Orthopaedics and Traumatology
关键词
股骨骨折
骨折固定术
外科手术
微创性
临床对照试验
Femoral fractures
Fracture fixation
Surgical procedures,minimally invasive
Controlled clinical trials