经皮加压钢板与空心加压螺钉治疗中青年移位股骨颈骨折的疗效比较

Comparison of curative effect between percutaneous compression plate and cannulated compression screw in the treatment of displaced femoral neck fractures in young and middle-aged patients

目的:比较经皮加压钢板与空心加压螺钉治疗中青年移位股骨颈骨折的疗效。方法:回顾分析2015年1月至2020年7月收治68例移位型中青年股骨颈骨折患者,其中31例采用经皮加压钢板(percutaneous compression plate,PCCP)固定,37例采用空心加压螺钉(cannulated compression screw,CCS)固定。收集两组患者性别、年龄、致伤原因、合并症、骨折分型及受伤原因等一般资料比较。两组患者的手术时间、术中出血量、住院时间、完全下地负重时间、骨折愈合时间、疼痛视觉模拟评分(visual analogue scale,VAS)、Harris髋关节评分及并发症。结果:两组患者均获2年以上随访。两组患者的手术时间、术中出血量、骨折复位质量、住院时间及VAS比较,差异无统计学意义(P>0.05)。PCCP组骨折愈合时间短于CCS组(t=-4.404,P=0.000)。PCCP组完全下地负重时间明显短于CCS组(t=-9.011,P=0.000)。术后2年PCCP组的髋关节Harris评分优于CCS组(P=0.002)。PCCP组有3例(9.68%)发生并发症,而CCS组出现了11例(29.72%)并发症,差异有统计学意义(P=0.042)。结论:PCCP及CCS均可用于治疗移位型中青年股骨颈骨折,相对于CCS,PCCP固定可以取得较短的骨折愈合时间,为患者早期完全负重创造条件。PCCP可以取得更高的髋关节Harris评分及较低的并发症。

Objective To compare the efficacy of percutaneous compression plate and cannulated compression screw in the treatment of displaced femoral neck fractures in young and middle-aged patients.Methods From January 2015 to July 2020,68 young and middle-aged patients with displaced femoral neck fracture were retrospectively analyzed.Among them,31 cases were fixed by percutaneous compression plate(PCCP),and 37 cases were fixed by cannulated compression screw(CCS).General data such as gender,age,cause of injury,comorbidities,fracture classification and cause of injury of two groups were collected.The operation time,intraoperative blood loss,hospital stay,full weight bearing time,fracture healing time,visual analogue scale(VAS),Harris hip score and complications were compared between two groups.Results Patients in both groups were followed up for more than 2 years.There were no significant differences in operation time,intraoperative blood loss,fracture reduction quality,hospital stay and VAS between two groups.The fracture healing time in PCCP group was significantly shorter than that in CCS group(t=-4.404,P=0.000).The complete weight bearing time of PCCP group was significantly shorter than that of CCS group(t=-9.011,P=0.000).Harris score of hip joint in PCCP group was better than that in CCS group 2 years after operation(P=0.002).Complications occurred in 3 cases(9.68%)in PCCP group,while 11 cases(29.72%)in CCS group,with a statistically significant difference(P=0.042).Conclusion Both PCCP and CCS can be used for the treatment of displaced femoral neck fractures in young and middle-aged people.Compared with CCS,PCCP fixation can achieve shorter fracture healing time and create conditions for early full weight bearing.PCCP results in higher hip score and lower complications.