股骨干骨折合并同侧股骨颈骨折的手术治疗方法及临床疗效观察

Methods and Effects of Surgical Treatment for Ipsilateral Fractures of Femoral Neck and Shaft

目的探讨股骨干骨折合并同侧股骨颈骨折的手术治疗方法及临床疗效。方法选取我院2012年3月至2015年12月期间收治的股骨干骨折合并同侧股骨颈骨折的患者35例,随机分为观察组18例和对照组17例。观察组采用锁定钢板固定手术方式,对照组采用髓内钉内固定。观察比较两组的住院时间、术中出血量、下床活动时间、股骨颈骨折愈合时间、股骨干骨折愈合时间等指标,并比较两组患者术后一年的髓关节功能恢复情况。结果两组患者的住院时间、术中出血量、股骨颈骨折愈合时间均无统计学差异(P>0.05),观察组的股骨干骨折愈合时间、下床活动时间均明显优于对照组,差异有统计学意义(P<0.05)。术后1年,观察组的髋关节功能优良率为94.4%,显著高于对照组的64.7%,差异有统计学意义(P<0.05)。结论采用锁定钢板固定治疗股骨干骨折合并同侧股骨颈骨折的效果显著优于髓内钉内固定治疗,值得在临床中推广应用。

Objective To investigate the methods and effect of surgical treatment for ipsilateral fractures of femoral neck and shaft. Methods A total of 35 cases of patients with ipsilateral frae^tres of femoral neck and shaft admitted to our hospital from March 2012 to December 2015 were selected as research objects. All cases were randomly divided into the observation group （n = 18） and the control group （n = 17）. Patients in the observation group were treated with anatomic locking plate fixation, while patients in the control group were treated with intramedullary nailing fixation. The length of hospital stay, intraoperative blood loss, time for ambulation, healing time of femoral neck fracture, and healing time of femoral shaft fracture were observed and compared between two groups. 1 year after surgery, the hip function recovery was observed and compared. Results No statistical difference was found between two groups in the length of hospital stay, intraoperafive blood loss and healing time of femoral neck fracture （P〉0.05）, while the time for ambulation and healing time of femoral shaft fracture of observation group were significantly shorter than those of control group （P〈0.05）. 1 year after surgery, the excellent and good rate of hip function of observation group was 94.4%, significantly higher than 64.7 % of control group （P 〈0.05）. Conclusions Anatomic locking plate fixation has better efficacy than intramedullary nailing fixation for patients with ipsilateral fractures of femoral neck and shaft, which is worthy of clinical promotion and application.