C型臂X线机监测下逆向闭合复位技术治疗外展嵌插型股骨颈骨折的临床效果

Clinical results of the C-arm X-ray monitored reverse closed reduction in the treatment of abductor-in-socket femoral neck fractures

目的分析C型臂X线机辅助下逆向闭合复位术对外展嵌插型股骨颈骨折的治疗效果。方法选择我院骨科于2020年1月至2021年11月收诊的外展嵌插型股骨颈骨折患者21例,均于C型臂X线机监测下行逆向闭合复位手术,术后X线复查患者的手术复位效果,随访观察患者术后并发症、髋关节功能恢复、生活质量等指标,以探讨该术式的临床应用价值。结果所有患者均顺利完成手术,无术中转开放手术者,术后第2天复查的X线片图像清晰,内固定物无改变,手术复位均理想。术后患者均接受随访,最短随访4个月,最长24个月,平均(17.6±6.09)个月,随访期间无感染、血栓等不良事件发生。末次随访时,有20例(95.24%)患者的髋关节功能恢复优良,Harris评分(88.4±7.85)分、生活质量评分(74.2±7.16)分,明显高于手术前各指标评分(P<0.05)。结论针对外展嵌插型股骨颈骨折,于C型臂X线机辅助监测下实施逆向闭合复位术,具有复位精准、创伤小、并发症风险低等优点,值得临床选择。

Objective To analyze the effectiveness of C-arm X-ray assisted reverse closed reduction in the treatment of abductor-in-socket femoral neck fractures.Methods Twenty-one patients with abductor-in-socket femoral neck fracture underwent C-arm X-ray assisted reverse closed reduction from January 2020 to November 2021.All were admitted to the Department of Orthopedics of the People’s Hospital of Bozhou.The reduction was evaluated by X-ray after the operation.Postoperative complications,functional recovery of the hip joint,quality of life and other indicators were assessed.Results All patients successfully completed the operation.None converted to open surgery.X-ray images on the 2nd postoperative day showed firm internal fixation and satisfactory surgical reduction.All patients were followed up after surgery,with a mean of(17.6±6.09)months(range:4-24 months).No infection or thrombosis occurred during the follow-up.At the final follow-up,20 patients(95.24%)had excellent recovery of hip functions,with Harris score(88.4±7.85)and quality of life score(74.2±7.16),which were significantly higher than those before surgery(P<0.05).Conclusions For abductor-in-socket femoral neck fracture,reverse closed reduction with the aid of C-arm X-ray monitoring has the advantages of precise reduction,less trauma,and low risk of complications,which is worthy of clinical promotion.