不同骨折分型方案与股骨颈骨折患者手术效果的相关性探讨

Relationship between fracture classification and therapeutic effect in patients with femoral neck fracture

目的评价不同骨折分型治疗方案对股骨颈骨折患者预后的影响。方法以2011年2月至2013年8月我院骨科收治的71例股骨颈骨折患者作为研究对象,根据Garden骨折分型方法、骨折线走行部位、骨折线倾斜角三种不同骨折分型方案将所有患者分为A、B、C、D、E、F组,分别为38例、33例、34例、37例、36例和35例。所有患者均给予空心加压螺纹钉内固定,对比术后各组的Harris髋关节功能评分情况,并对各组患者术后出现的不良事件进行统计分析。结果与GardenI型、Ⅱ型、头下型骨折比较,Ⅲ、Ⅳ型与头颈型、经颈型骨折患者的Harris评分均有不同程度的降低,且固定断裂、松动、畸形愈合、股骨头坏死的发生率明显增加,差异均有统计学意义(P<0.05)。结论不同股骨颈骨折分型在评估股骨颈骨折预后方面的作用不同。

Objective To explore the relationship between fracture classification and therapeutic effect in pa-tients with femoral neck fracture. Methods Seventy-one patients with femoral neck fracture treated in the department of orthopedics in our hospital from February 2011 to August 2013 were selected as research subjects, which were divided into A to F groups according to three different fracture classification schemes, Garden classification, classification by fracture line linear and Pauwels classification. The case number in A to F groups were 38, 33, 34, 37, 36 and 35, respec-tively. Cannulated screw fixation was given to all the patients after surgery. The harris hip scores and incidence of compli-cations in each group were compared. Results Compared with Garden typeⅠ, typeⅡ, and under head cases, the harris scores were statistically significantly lower in typeⅢ, typeⅣ, head and neck cases, neck cases, and the occurrence rates of broken and loose of fixation, malunion and osteonecrosis were significantly increased （P〈0.05）. Conclusion Differ-ent fracture classification schemes had divers functions in assessing the prognosis of non-femoral neck fracture.