平乐手法复位结合全螺纹空心钉在骨质疏松GardenⅢ型股骨颈骨折临床应用研究

Clinical Application of Pingle Manipulative Reduction and Full Thread Hollow Nail in Osteoporotic Garden III Femoral Neck Fracture

目的:分析平乐手法复位结合全螺纹空心钉应用于骨质疏松GardenⅢ型股骨颈骨折的效果。方法:选取2015年6月—2016年5月骨质疏松GardenⅢ型股骨颈骨折患者60例,均采用平乐手法复位,根据固定方法不同分为3组,其中20例患者以全螺纹空心钉固定为试验1组,20例患者选择单头半螺纹空心钉结合全螺纹空心钉固定为试验2组,另20例患者选择单头空心钉固定为对照组,比较3组术后不同时期髋关节功能(Harris评分)、骨折愈合时间及骨折不愈合发生率。结果:术后2个月、术后4个月、术后6个月、术后12个月、术后18个月3组Harris评分比较差异有统计学意义,且试验1组Harris评分最高;3组骨折愈合时间、骨折不愈合发生率比较差异有统计学意义,且试验1组骨折愈合时间最短、未出现骨折不愈合情况;3组股骨头坏死发生率比较无明显差异。结论:全螺纹空心钉内固定治疗骨质疏松GardenⅢ型股骨颈骨折患者,可有效改善髋关节功能,降低股骨头坏死及骨折不愈合发生率,对改善患者预后有积极作用。

Objective:To analyze the effect of Pingle manipulative reduction combined with full-thread hollow nails in osteoporotic GardenⅢfemoral neck fractures.Methods:A total of 60 patients with osteoporotic GardenⅢfemoral neck fractures from June 2015 to May 2016 were selected.They were all reduced by Pingle technique and divided into 3 groups according to different fixation methods.Among them,20 patients were treated with full-thread hollow nails.Fixation was set as test group 1.20 patients chose single-head half-threaded hollow nails combined with full-threaded hollow nails as test group 2,and the other 20 patients chose single-head hollow nails as the control group to compare the hip joints of the 3 groups at different postoperative periods Function(Harris score),fracture healing time,and incidence of fracture nonunion.Results:Two months after operation,4 months after operation,6 months after operation,12 months after operation,and 18 months after operation,the Harris scores of the three groups had statistically significant differences,and the Harris score of test 1 group was the highest;There was a statistically significant difference in the fracture healing time and the incidence of fracture nonunion between the three groups,and the test 1 group had the shortest fracture healing time without fracture nonunion;there was no significant difference in the incidence of femoral head necrosis in the three groups.Conclusion:The internal fixation with full screw hollow nails in the treatment of osteoporotic GardenⅢfemoral neck fractures can effectively improve hip joint function,reduce the incidence of femoral head necrosis and fracture nonunion,and have a positive effect on improving the prognosis of patients.