空心螺钉与动力髋螺钉加防旋螺钉治疗股骨颈骨折疗效比较

Comparison of cannulated screws and dynamic hip screws plus anti-rotation screw in treatment of femoral neck fracture

目的比较分析空心螺钉与动力髋螺钉加防旋螺钉治疗股骨颈骨折的临床疗效。方法将35例应用空心螺钉治疗的股骨颈骨折患者设立为A组,另选择同期35例应用动力髋螺钉加防旋螺钉治疗的股骨颈骨折患者设立为B组,比较两组的临床手术观察指标、临床疗效和并发症情况。结果与B组比较,A组手术切口小、手术时间短、术中出血量少、骨折愈合时间短、术后住院时间短,但Harris评分低于B组,差异有统计学意义(P<0.05)。与A组比较,B组无一例发生骨折不愈合,无一例内固定失败,无一例股骨头缺血性坏死发生,B组也无一例进行再次手术,疗效明显优于A组,差异有统计学意义(P<0.05)。结论空心螺钉与动力髋螺钉加防旋螺钉治疗股骨颈骨折的临床疗效较好,DHS联合防旋螺钉较空心螺钉内固定并发症少、再次手术率低,而空心螺钉术具有手术切口小、手术时间短、术中出血量少、骨折愈合时间短、术后住院时间短等优点,两种术式各具优缺点,值得广大临床医生予以关注。

Objective To compare the clinical efficacy of hollow screws and dynamic hip screw and the of anti-rotary screw fixation of femoral neck fracture. Methods Thirty-five patients were treated with cannulated screws treatment of femoral neck fracture patients to set up for group A, another selected the same period 35 cases dynamic hip screw and anti-rotation screw for treatment of femoral neck fractures in patients with the establishment of group B, clinical efficacy and complications were compared between the two groups. Results Compared with group B, group A surgical incision was small, shorter operative time, less blood loss, fracture healing time was short, shorter postoperative hospital stay, but the Harris hip score was lower in group A, the difference was statistically significance between two groups. Compared with group A, group B and no case of nonunion, no-one cases of fixation failure cases, avascular necrosis cases occur, the group B was also no case of reoperation, the effect were significantly better than group A （P 〈 0.05）. Conclusion The clinical ef- ficacy of cannulated screws and dynamic hip screw anti-rotation screws for femoral neck fractures is better, the DHS joint an- ti-rotation screws compared with eannulated screw fixation have few complications, reoperation rate is low, hollow screw surgery with small incision surgery. Shorter operative time, less blood loss, fracture healing time is short, shorter postopera- tive hospital stay,etc.,each with advantages and disadvantages of the two procedures, it is worth the majority of clinicians to be concerned.