DAA入路空心钉联合支撑钢板切开复位内固定治疗股骨颈骨折的疗效观察

Effect of open reduction and internal fixation with cannulated screw and supporting plate via DAA approach in the treatment of femoral neck fracture

目的观察直接前侧入路(DAA)空心钉联合支撑钢板切开复位内固定治疗股骨颈骨折的疗效。方法106例股骨颈骨折患者,按照治疗方案的不同分为对照组与研究组,各53例。对照组采用常规闭合复位经皮空心钉内固定治疗,研究组采用DAA入路空心钉联合支撑钢板切开复位内固定治疗。比较两组患者围手术期指标,术后1、3个月的功能、疼痛评分。结果研究组手术时间(72.45±10.56)min长于对照组的(43.39±5.72)min,术中出血量(352.53±48.77)ml多于对照组的(76.76±13.58)ml,术后并发症发生率11.32%低于对照组的32.08%,差异有统计学意义(P<0.05)。术后3个月,两组功能、疼痛评分均优于本组术后1个月,且研究组优于对照组,差异均有统计学意义(P<0.05)。结论在股骨颈骨折患者的治疗中,以DAA入路空心钉联合支撑钢板切开复位内固定治疗,虽较传统手术时间较长,出血量相对较多,但可明显的减少术后并发症的发生,并改善髋关节功能,减轻术后疼痛,效果理想。

Objective To observe the efficacy of open reduction and internal fixation with cannulated screw and supporting plate via direct anterior approach(DAA)in the treatment of femoral neck fracture.Methods A total of 106 patients with femoral neck fractures were divided into the control group and the research group according to the difference of the scheme,with 53 cases in each group.The control group underwent conventional closed reduction and percutaneous cannulated screw internal fixation,and the research group underwent open reduction and internal fixation with cannulated screw and supporting plate via DAA.Both groups were compared in terms of perioperative indicators,and the function score and pain scores at 1 and 3 months postoperatively.Results The operation time(72.45±10.56)min of the research group was longer than(43.39±5.72)min of the control group,the intraoperative blood loss(352.53±48.77)ml was more than(76.76±13.58)ml of the control group,and the postoperative complication rates 11.32%was lower than 32.08%of the control group.All the differences were statistically significant(P<0.05).At 3 months postoperatively,the function score and pain score of the two groups were better than those of this group at 1 month postoperatively,and the research group was better than the control group.All the differences were statistically significant(P<0.05).Conclusion In the treatment of patients with femoral neck fracture,open reduction and internal fixation with DAA cannulated screw and supporting plate can significantly reduce the postoperative complication rates,improve hip joint function and relieve postoperative pain,although the operation time is longer and the amount of bleeding is relatively more than traditional operation.