CCS和DHS-B治疗股骨颈骨折疗效及对生物力学的影响

Effects of CCS and DHS-B on femoral neck fracture and their influences on biomechanics

目的 研究空心加压螺钉(CCS)和动力髋螺钉螺旋刀片(DHS-B)治疗股骨颈骨折疗效及对生物力学的影响。方法 将74例股骨颈骨折患者随机均分为CCS组和DHS组进行治疗,比较两组治疗效果。结果 两组患者术后骨痂生长评分随时间延长逐渐升高,组内各时间点差异有统计学意义(P<0.05),两组间同一时间点差异有统计学意义(P<0.05);CCS组内外侧应变值、水平和垂直方向偏移距离以及断面张开角均明显大于DHS组(P<0.05),极限荷载量明显小于DHS组(P<0.05);随访6个月时,CCS组Harris评分各项目得分及总分均明显低于DHS组(P<0.05)。结论 CCS和DHS-B均为临床广泛应用的内固定材料,用于股骨颈骨折效果良好,且DHS-B具有更佳的设计优势,相较于CCS更符合股骨生物力学特性,故治疗效果更好。

Objective To study the effects of cannulated compression screw(CCS)and dynamic hip screw blade(DHS-B)on femoral neck fracture and their influences on biomechanics.Method 74 patients with femoral neck fracture were randomly divided into CCS group and DHS group,and the effects of the two groups were compared.Results After operation,the callus growth scores in the two groups both increased with time,the differences of time points in each group were statistically significant(P<0.05),and the differences between the two groups at every time point were statistically significant(P<0.05).The internal and external strain values,horizontal and vertical offset distance,and section opening angle in the CCS group were all larger than those in the DHS group(P<0.05);the ultimate load capacity in the CCS group was less than that in the DHS group(P<0.05).After 6 months of follow-up,the scores of each item and total score of Harris scale in the CCS group were significantly lower than those in the DHS group(P<0.05).Conclusions CCS and DHS-B are both widely used internal fixation materials,which have good effects in femoral neck fracture.Compared with CCS,DHS-B has design advantages,more suitable for femoral biomechanical characteristics,therefore,its treatment effect is better