解剖复位、Gotfried支撑复位用于青年股骨颈骨折的远期随访观察

Long-term follow-up study of anatomical reduction and Gotfried support reduction for young femoral neck fracture

目的探讨解剖复位、Gotfried支撑复位用于青年股骨颈骨折的远期应用价值。方法回顾性分析我院96例青年股骨颈骨折患者的临床资料,其中行Gotfried阳性支撑复位(观察组)与解剖复位(对照组)各48例。随访3年,全部随访成功。观察两组术后1年骨折复位质量,记录术后1年、2年、3年髋关节功能Harris评分优良率,对比术后末次随访并发症发生率。结果两组骨折复位质量比较无显著性差异(P>0.05)。两组术后1年、2年、3年髋关节功能Harris评分优良率比较差异无统计学意义(P>0.05)。观察组术后并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。结论 Gotfried阳性支撑复位与解剖复位在骨折复位质量及改善髋关节功能方面效果相当,但Gotfried阳性支撑复位可降低术后并发症发生率,若实现Gotfried阳性支撑复位,无需过度追求解剖复位。

Objective To evaluate the long-term application value of anatomical reduction and Gotfried support reduction in the treatment of femoral neck fractures in young adults. Methods The clinical data of 96 young patients with femoral neck fracture in our hospital were retrospectively analyzed, including Gotfried positive support reduction（observation group,n=48） and anatomic reduction operation（control group,n=48）. The fracture reduction quality of the two groups was observed after 1 years,and the excellent rate of Harris score of hip function was recorded at 1,2 and 3 years after operation. The complication rate was compared at the last follow-up. ResultsThere was no significant difference in the quality of fracture reduction between the two groups（P〈0.05）. There was no significant difference between the two groups in the 1 year,2 year and 3 year hip function Harris score（P〈0.05）. The complication rate of the observation group was significantly lower than the control group,and the difference was statistically significant（P〈0.05）. Conclusion The effect of Gotfried positive support reduction and anatomical reduction on the quality of fracture reduction and the improvement of hip function is equivalent. Gotfried positive support reduction can reduce the incidence rate of complications. If Gotfried positive support reduction is achieved,there is no need for excessive anatomical reduction.