“F”形空心钉与空心螺钉内固定治疗股骨颈骨折的效果比较

Comparison of the Effect of"F"Shaped Hollow nail and Hollow Screw Internal Fixation on Femoral Neck Fracture

目的探讨股骨颈骨折患者采用"F"形空心钉技术与传统空心螺钉固定治疗的效果。方法选择2017年1月~2018年12月我院接收的89例股骨颈骨折患者作为研究对象,根据布钉方式不同将其分为对照组(43例)及实验组(46例),对照组给予传统空心螺钉固定技术(正三角形固定)治疗,实验组给予"F"形空心钉技术治疗。比较两组骨折不愈合、固定失效、坏死、股骨颈短缩移位等不良结局、手术指标(手术时间、术中出血量、C型臂透视时间、骨折愈合时间、内固定后开始负重时间、住院时间)、复位指数及髋关节功能情况。结果实验组手术时间、术中出血量、C型臂透视时间、骨折愈合时间、内固定后开始负重时间、住院时间分别为(47.65±5.52)min、(23.52±7.50)ml、(21.03±10.14)s、(100.65±10.69)d、(2.11±0.98)个月、(7.59±2.02)d,均低于对照组的(60.32±6.32)min、(30.36±9.40)ml、(28.74±11.16)s、(116.32±12.31)d、(3.12±1.03)个月、(9.36±2.32)d,差异均有统计学意义(P<0.05);实验组术后不良结局发生率(23.91%)低于对照组(44.17%),且髋关节功能恢复优良率(95.65%)高于对照组(79.07%),差异有统计学意义(P<0.05);实验组骨折复位情况优于对照组,差异有统计学意义(P<0.05)。结论"F"形空心钉技术治疗股骨颈骨折效果较好,不仅可降低股骨颈短缩移位发生率,促进患者术后骨折愈合,减少不良结局的发生,还能促进髋关节功能恢复及骨折复位。

Objective To investigate the effect of"F"shaped hollow nail technique and traditional hollow screw fixation in patients with femoral neck fracture.Methods A total of 89 patients with femoral neck fractures received in our hospital from January 2017 to December 2018 were selected as the research object,and they were divided into a control group(43 cases)and an experimental group(46 cases)according to different cloth nailing methods.The control group was treated with traditional cannulated screw fixation technique(positive triangle fixation),and the experimental group was treated with"F"shaped hollow nail technique.Comparison of adverse outcomes such as fracture nonunion,fixation failure,necrosis,femoral neck shortening and displacement,surgical indicators(surgery time,intraoperative blood loss,C-arm fluoroscopy time,fracture healing time,time to start weight bearing after internal fixation,hospitalization time),reduction index and hip joint function.Results In the experimental group,the operation time,intraoperative blood loss,C-arm fluoroscopy time,fracture healing time,weight-bearing time after internal fixation,and hospitalization time were(47.65±5.52)min,(23.52±7.50)ml,(21.03±10.14)s,(100.65±10.69)d,(2.11±0.98)months,(7.59±2.02)d,all were lower than(60.32±6.32)min,(30.36±9.40)ml,(28.74±11.16)s,(116.32±12.31)d,(3.12±1.03)months,(9.36±2.32)d of the control group,the difference were statistically significant(P<0.05);the incidence of adverse outcomes in the experimental group(23.91%)was lower than that in the control group(44.17%),and the excellent rate of hip joint function recovery(95.65%)was higher than that in the control group(79.07%),the difference was statistically significant(P<0.05);the fracture reduction of the experimental group was better than the control group,the difference was statistically significant(P<0.05).Conclusion The"F"shaped hollow nail technique is effective in treating femoral neck fractures.It not only reduces the incidence of femoral neck shortening and displacement,promotes postoperative fracture healing,reduces the occurrence of adverse outcomes,but also promotes hip function recovery and fracture reset.