股骨重建钉与股骨逆行髓内钉加空心钉治疗同侧股骨干合并股骨颈骨折的效果比较

Comparison of reconstruction interlocking nail versus hollow screw combined with retrograde intramedullary interlocking nail internal fixation in the treatment of ipsilateral fractures of femoral neck and shaft

目的比较股骨重建钉与股骨逆行髓内钉加空心钉治疗同侧股骨干合并股骨颈骨折的效果。方法抽取2012年2月至2019年10月汾阳医院收治的股骨干骨折合并骨颈骨折患者62例,依据治疗方案分为两组。A组31例行股骨重建钉治疗,其中骨折处有移位5例(A1组),无移位26例(A2组);B组31例行股骨逆行髓内钉加空心钉治疗,其中骨折处有移位6例(B1组),无移位25例(B2组)。回顾性分析各组围术期指标、并发症、髋关节功能。结果B2、B1组手术时间长于A1、A2组(P<0.05)。B1、A2组发生并发症率分别为0、11.54%(3/26),低于B2、A1组的20.00%(5/25)、60.00%(3/5),P<0.05。术后6个月,B1、A2组髋关节功能优良率为100%(6/6)、100%(26/26),高于A1、B2组的80.00%(4/5)、96.00%(24/25),P<0.05。结论股骨重建钉与股骨逆行髓内钉加空心钉治疗同侧股骨干合并股骨颈骨折患者均有一定疗效,无移位者适宜选择股骨重建钉治疗,有明显移位者更适宜选择逆行髓内钉加空心钉分别固定。

Objective To investigate the efficacy of reconstruction interlocking nail and hollow screw combined with retrograde intramedullary interlocking nail internal fixation in the treatment of ipsilateral fractures of femoral neck and shaft.Methods A total of 62 patients with ipsilateral fractures of femoral neck and shaft admitted to Fenyang Hospital from February 2012 to October 2019 were selected,and divided into two groups according to the treatment plan.Thirty-one patients in group A were treated with reconstruction interlocking nail.Among them,there were 5 cases with displacement of the fracture(group A1)and 26 cases without displacement(group A2);thirty-one patients in group B were treated with hollow screw combined with retrograde intramedullary interlocking nail internal fixation.Among them,there were 6 cases of fracture displacement(group B1)and 25 cases without displacement(group B2).Perioperative indexes,complications,and hip joint function of each group were analyzed retrospectively.Results The operation time of group B2 and B1 were longer than those of group A1 and A2(P<0.05).The complication rates of group B1 and A2 were 0 and 11.54%(3/26),respectively,which were lower than 20.00%(5/25)and 60.00%(3/5)of group B2 and A1,P<0.05.Six months after the operation,the excellent and good rate of hip joint function of group B1 and A2 was 100%(6/6)and 100%(26/26),which were higher than 80.00%(4/5)and 96.00%in group A1 and B2.(24/25),P<0.05.Conclusions Both reconstruction interlocking nail and hollow screw combined with retrograde intramedullary interlocking nail internal fixation is effective in the treatment of ipsilateral fractures of femoral neck and shaft.Reconstruction interlocking nail is better for patients without displacement for its shorter operation time,meanwhile,hollow screw combined with retrograde intramedullary interlocking nail internal fixation is better for patients with displacement.