股骨颈骨折空心螺钉内固定术后股骨颈短缩发生率及对患者预后的影响

Incidence of Femoral Neck Shortening after Femoral Neck Fracture Cannulated Screw Fixation and Its Effects on Patients' Prognosis

目的研究股骨颈骨折空心螺钉内固定术后股骨颈短缩发生率及对患者预后的影响。方法选取我院骨科收治的股骨颈骨折患者78例,随机分为研究组和对照组,每组39例,研究组行空心螺钉内固定术、对照组行人工股骨头置换术,比较两组手术基本情况并进行1年随访,了解两组术后1年内股骨颈短缩率、骨折愈合率,同时比较两组预后情况包括Harris评分、并发症发生情况。结果与对照组相比,研究组手术时间(62.47±11.18)min、下床活动时间(14.16±1.72)d、住院时间(16.78±2.41)d显著较短,术中出血量(87.40±14.60)m L较少(P<0.01);研究组1年内股骨颈短缩率29.72%略低于对照组、骨折愈合率91.89%略高于对照组,两组股骨颈短缩率、骨折愈合率比较无统计学意义(P>0.05);研究组Harris评分(82.46±5.87)分明显低于对照组(P<0.05),并发症发生率略高于对照组,比较差异无统计学意义(P>0.05)。结论股骨颈骨折空心螺钉内固定术手术时间、下床时间、住院时间、失血量等手术基本情况优于人工股骨头置换术,股骨颈短缩率、骨折愈合率较满意,但预后Harris评分、并发症发生率方面效果不如人工股骨头置换术,故骨折空心螺钉内固定术优缺点明显,临床可根据患者实际情况选择。

Objective To study incidence of femoral neck shortening after femoral neck fracture cannulated screw fixation and its effects on patients＇ prognosis..Methods Seventy-eight patients with transcervical fracture treated in department of orthopedics of our hospital from May 2014 to May 2015 were selected, they were randomly divided into study group and control group, 39 cases in each group, study group underwent cannulated screw fixation, control group underwent artificial femoral head replacement, basic operation conditions in the two groups were compared, all patients were followed up in a year, incidence of femoral neck shortening, fracture healing rate in the two groups in 1 year after surgery were understood, prognosis including Harris scores, occurrence of complications in the two groups were compared. Results Compared with those the control group, operation time （62.47±11.18）min, activity time by getting out of bed （14.16±1.72）d, length of stay （16.78±2.41）d in study group were significantly shorter, intraoperative blood loss （87.40±14.60） mL was significantly less （P〈0.01）, incidence of femoral neck shortening in 1 year in study group 29.72% was slightly lower than control group, fracture healing rate 91.89% was slightly higher than control group, but there was no significant difference in incidence of femoral neck shortening and fracture healing rate in the two groups （P〉0.0B）; Harris scores （82.46±5.87）score in study group was significantly lower than control group （P〈0.05）, complication rate was slightly higher than control group, there was no significant difference in the two groups （P〉0.05）. Conclusion Operation time, activity time by getting out of bed, length of stay, blood loss and other basic operation conditions of femoral neck fracture cannulated screw fixation are better than artificial femoral head replacement, incidence of femoral neck shortening and fracture healing rate are satisfied, but prognosis Harris scores, complication rate are not better than artificial femoral head replacement. So advantages and disadvantages of fracture cannulated screw fixation are obvious, it can be selected according to actual circumstance of patients in clinic.