Gotfried支撑复位结合内固定对中青年股骨颈骨折患者髋关节功能及血流动力学的影响

Effect of Gotfried supported reduction and internal fixation on hip joint function and hemodynamics in young and middle-aged patients with femoral neck fracture

目的探讨Gotfried支撑复位结合内固定对股骨颈骨折的中青年患者髋关节功能及血流动力学的影响。方法选取2010年4月-2015年8月该院就诊的中青年股骨颈骨折患者按处理方式不同分为:A组(单采用闭合复位螺钉内固定);B组(Gotfried支撑复位+闭合复位螺钉内固定);C组(解剖复位);每组35例。比较3组患者术中血流动力学变化、住院时间以及术后1年颈短缩发生情况、髋关节Harris评分差异。结果治疗过程中A、B两组收缩压、舒张压及心率变化幅度弱于C组患者,且B组住院时间(8.5±3.2)d短于A组(8.9±3.2)d及C组(8.9±3.5)d,差异有统计学意义(P<0.05)。此外,随访1年后,B组(68.6%)及C组(65.7%)未发生颈短缩比例高于A组(37.1%),且B组(86.2±6.1)及C组(85.3±6.9)髋关节Harris评分均高于A组(76.9±6.6),差异有统计学意义(P<0.05);但3组的股骨头缺血性坏死发生率差异无统计学意义(P>0.05)。结论Gotfried支撑复位结合内固定又助于降低治疗对患者血流动力学的影响,缩短患者住院时间,并有利于预防术后发生颈短缩以及提高髋关节功能。

Objective To investigate the effect of Gotfried supported reduction and internal fixation on hip function and hemodynamics in young and middle-aged patients with femoral neck fracture. Methods The young and middle-aged patients with femoral neck fracture treated in our hospital from April 2010 to August 2015 were divided into group A （internal fixation with closed reduction screw alone）, group B （Gotfried support reset plus closed reduction screw fixation） and group C （anatomic reduction） according to different treatments, with 35 patients in each group. Hemodynamic changes, length of hospital stay, incidence of neck shortening 1 year after operation and Harris scores were compared between the two groups. Results During the treatment, the changes of systolic blood pressure, diastolic blood pressure and heart rate in group A and B were lower than those in group C, and the length of stay in group B （8.5 ± 3.2 days） was less than that in group A （8.9 ± 3.2 days） and group C （8.9 ± 3.5 days）, the differences were statistically significant （ P〈0.05）. In addition, after one year＇s follow-up, the incidence of no neck shortening in group B （68.6%） and group C （65.7%） was significantly higher than that in group A （37.1%）, and Harris scores in group B （86.2 ± 6.1） and group C （85.3 ± 6.9） were significantly higher than those in group A （76.9 ± 6.6）, but there were no significant differences in the incidence of avascular necrosis of femoral head among the three groups. Harriss scores in group B （86.2 ± 6.1） and group C （85.3 ± 6.9） were higher than those in group A （76.9 ± 6.6）, but there were no significant differences among the three groups in the incidence of avascular necrosis of femoral head. Conclusions Gotfried supported reduction and internal fixation help to reduce the hemodynamic effect of treatment on patients, shorten the length of stay in patients, improve hip function and be conducive to the prevention of postoperative neck shortening.