空心钉与空心钉钢板内固定治疗股骨颈骨折疗效比较

Curative effects comparison of cannulated screw and cannulated screw with plate in the treatment of femoral neck fracture

目的比较空心钉与空心钉钢板内固定治疗股骨颈骨折的疗效。方法将68例股骨颈骨折患者根据治疗方式分为空心钉组(37例)和空心钉钢板组(31例)。比较两组切口长度、手术时间、术中出血量、并发症、骨折愈合率和术后6个月髋关节Harris评分。结果手术切口均一期愈合。切口长度、手术时间、术中出血量空心钉组均少(短)于空心钉钢板组(P<0.05)。两组患者均获得随访,时间6~41(21.7±10.8)个月。术后6个月,股骨头坏死及骨折不愈合例数空心钉组均多于空心钉钢板组,但差异无统计学意义(P>0.05);股骨颈短缩及螺钉松动、退出例数空心钉组均多于空心钉钢板组,差异有统计学意义(P<0.05);髋关节Harris评分空心钉组低于空心钉钢板组(P<0.05)。结论空心钉和空心钉钢板内固定治疗股骨颈骨折均可获得较好的临床疗效,空心钉钢板内固定能获得更加稳固的支撑,对患肢早期功能锻炼更有利。

Objective To compare the effect of cannulated screw and cannulated screw with plate in the treatment of femoral neck fracture.Methods The 68 patients with femoral neck fractures were divided into the cannulated screw group(37 cases)and the cannulated screw with plate group(31 cases)according to the fixation methods.The length of incision,operation time,intraoperative blood loss volume,complications,fracture healing rate,and hip Harris score at 6 months after surgery were compared between the two groups.Results All the surgical incisions were healed in one stage.The length of the incision,operation time,and the volume of intraoperative blood loss in the cannulated screw group were less(shorter)than those in the cannulated screw with plate group(P<0.05).All patients were followed up for 6~41(21.7±10.8)months.At 6 months postoperation,the incidence cases of femoral head necrosis and fracture nonunion in the cannulated screw group were more than those in the cannulated screw with plate group,while there were no significant differences between the two groups(P>0.05).The incidence cases of femoral neck shortening and screw loosening or withdrawal in the cannulated screw group were more than in the cannulated screw with plate group,with satatistical significances(P<0.05).Hip Harris score in cannulated screw group was lower than that in cannulated screw with plate group(P<0.05).Conclusions The cannulated screw and cannulated screw with plate can achieve better clinical results in the treatment of femoral neck fracture.The cannulated screw with plate can obtain more stable support,which are more beneficial to early functional exercise for affected limb.