股骨颈系统对PauwelsⅡ型股骨颈骨折患者的影响

Effect of Femoral Neck System on Patients with Pauwels TypeⅡFemoral Neck Fracture

目的:探究股骨颈系统(FNS)对PauwelsⅡ型股骨颈骨折患者的影响。方法:回顾性分析2017年6月—2019年6月远安县人民医院收治的80例PauwelsⅡ型股骨颈骨折患者的临床资料。根据治疗方式的不同将其分为A组(n=42)和B组(n=38)。A组采用FNS治疗,B组采用空心螺钉内固定治疗。比较两组围手术期指标,术前及术后3 d疼痛程度,术前及术后1个月心理状态、日常生活功能及术后3个月骨折愈合情况,并发症。结果:A组住院时间、手术时间均短于B组,骨折愈合时间、完全负重时间均早于B组,差异有统计学意义(P<0.05)。术后3 d,A组视觉疼痛模拟量表(VAS)评分明显低于B组,术后1个月,心理弹性量表(CD-RISC)评分明显高于B组,差异有统计学意义(P<0.05)。术后3个月,A组骨折愈合评分系统(RUSS)明显高于B组,术后1个月,A组功能独立性评价量表(FIM)评分均明显高于B组,差异有统计学意义(P<0.05)。术后3年内,两组股骨颈短缩、骨折不愈合、股骨头坏死、髋内外翻畸形发生率及并发症总发生率比较差异均无统计学意义(P>0.05)。结论:采用FNS可有效促进PauwelsⅡ型股骨颈骨折患者骨折愈合,提高其功能恢复效果。

Objective:To investigate the effect of femoral neck system(FNS)on patients with Pauwels typeⅡfemoral neck fracture.Method:The clinical data of 80 patients with Pauwels typeⅡfemoral neck fracture admitted to Yuan’an County People's Hospital from June 2017 to June 2019 were retrospectively analyzed.They were divided into group A(n=42)and group B(n=38)according to different treatment methods.Group A was treated with FNS,and group B was treated with hollow screw internal fixation.The perioperative indicators,preoperative and postoperative 3 d pain degree,psychological state,daily life function before and 1 months after operation,postoperative fracture healing degree 3 months after operation,and complications were compared between the two groups.Result:The hospitalization time and operation time in group A were shorter than those in group B,the fracture healing time and full weight-bearing time were earlier than those in group B,the differences were statistically significant(P<0.05).Three d after operation,the visual pain analogue scale(VAS)score of group A was significantly lower than that of group B,1 month fter operation,the Connor-Davidson resilience scale(CD-RISC)score was significantly higher than that of group B,and the differences were statistically significant(P<0.05).Three months after operation,the fracture healing scoring system(RUSS)score of group A was higher than that of group B,1 months after operation the functional independent measures(FIM)score of group A was significantly higher than that of group B,the differences were statistically significant(P<0.05).Within 3 years after operation,there were no significant differences in the incidence of femoral neck shortening,fracture nonunion,femoral head necrosis,hip internal and external varus deformity and the total incidence of complications between the two groups(P>0.05).Conclusion:The use of FNS can effectively promote fracture healing in patients with Pauwels typeⅡfemoral neck fracture,and improve the their functional recovery effect.