股骨短缩与青年股骨颈骨折内固定术后功能效果的关系分析

Analysis of the Relationship between Femur Shortening and Function Effects after Internal Fixation of Femoral Neck Fractures in Youth

目的:探讨青年股骨颈骨折内固定术后股骨短缩的发生情况,以及中期随访时股骨短缩与功能之间的关系。方法:选取2014年1月-2016年12月采用闭合复位空心钉内固定治疗的29例股骨颈骨折患者作为研究对象。在术后3个月及1年进行站立位X线检查,了解股骨短缩及功能情况。结果:术后3个月时有17例发生股骨短缩,股骨短缩发生率为58.6%,术后3个月平均短缩(7.5±1.3)mm。术后1年进行复查时,发生短缩的病例数一般没有进一步增加;术后1年平均短缩(9.1±2.1)mm。股骨短缩患者与非股骨短缩患者年龄、性别、致伤原因、手术时间、入院至入手术室时间、HHS评分、VAS评分、UCLA评分比较差异均无统计学意义(P>0.05);股骨短缩患者与非股骨短缩患者Garden分型、AO-OTA分型、Pauwells角、BMI比较,差异有统计学意义(P<0.05)。结论:采用内固定治疗的青年股骨颈骨折患者虽然在中期随访中股骨短缩的发生率较高,但未发现股骨颈短缩对患肢功能有明显影响。

Objective:To investigate the occurrence of femur shortening after internal fixation of femoral neck fracture in youth and the relationship between femur shortening and function during mid-term follow-up.Method:A total of 29 patients with femoral neck fracture treated with closed reduction cannulated internal fixation from January 2014 to December 2016 were selected as the research objects.Standing X-ray examination was performed at 3 months and 1 year postoperatively to understand femur shortening and function.Result:Femur shortening occurred in 17 patients 3 months after the operation,with an incidence of 58.6%,and an average shortening was(7.5±1.3)mm 3 months after the operation.At the time of reexamination 1 year after the operation,the number of cases with shortening generally did not increase further.The average shortening was(9.1±2.1)mm 1 year after the operation.There were no statistically significant differences in age,gender,cause of injury,operation time,admission to the operating room,HHS score,VAS score and UCLA score between patients with femoral shortening and patients without femoral shortening(P>0.05).There were statistically significant differences between the two groups in Garden classification,AO-OTA classification,Pauwells angle,BMI between patients with femoral shortening and patients without femoral shortening(P<0.05).Conclusion:Although the incidence of femoral shortening in young patients with femoral neck fracture treated by internal fixation is high in the mid-term follow-up,there is no significant effect of femoral neck shortening on limb function.