VN分型对股骨颈骨折患者空心螺钉内固定治疗后的远期预后评估价值研究

Value of VN typing in evaluating long-term prognosis of patients with femoral neck fracture after cannulated screw internal fixation

目的 分析颈垂角(VN)分型评估股骨颈骨折患者空心螺钉内固定治疗后远期预后的价值。方法 回顾性分析行空心螺钉内固定治疗的94例股骨颈骨折患者,并进行VN分型。对所有患者进行随访,观察固定失败、骨折不愈合及股骨头坏死的发生情况。结果 94例股骨颈骨折患者中VN分型为Ⅰ型34例、Ⅱ型30例、Ⅲ型22例、Ⅳ型8例。所有患者进行了6~36个月的随访。随访期间,12例(12.77%)患者发生内固定失败。8例(8.51%)股骨颈骨折患者发生股骨颈骨折不愈合,86例(91.49%)患者骨折愈合,愈合时间为(5.65±1.31)个月。11例(11.70%)患者发生股骨头坏死,发生时间为(17.32±4.02)个月。VN分型与术后内固定失败有关(Z=-5.25,P<0.05),对术后骨折不愈合和股骨头坏死无明显相关(Z分别=0.17、0.45,P均>0.05)。结论 VN分型与股骨颈骨折空心螺钉内固定治疗患者的预后有关。

Objective To analyze the value of vertical neck angle(VN)classification in evaluating the long-term prognosis of patients with femoral neck fracture treated with hollow screw internal fixation.Methods A retrospective analysis was made of 94 cases of femoral neck fracture treated with hollow screw internal fixation.All patients were fol⁃lowed up to observe the occurrence of failure of fixation,nonunion of fracture and femoral head necrosis.Results Of the 94 femoral neck fracture patients,34 cases were typeⅠof VN classification,30 cases were typeⅡ,22 cases were typeⅢand 8 cases were typeⅣ.All patients were followed up for 6 to 36 months.During follow-up,12(12.77%)pa⁃tients experienced internal fixation failure.Femoral neck fracture nonunion occurred in 8(8.51%)patients,and fractu⁃reunion occurred in 86(91.49%)patients,and the healing time was(5.65±1.31)months.Eleven patients(11.70%)de⁃veloped femoral head necrosis,the occurrence time was(17.32±4.02)months.VN classification is associated with postop⁃erative internal fixation failure(Z=-5.25,P<0.05),but is not significant correlated with postoperative fracture non union and femoral head necrosis(Z=0.17,0.45,P>0.05).Conclusion VN classification is related to the prognosis of patients treated with femoral neck fracture hollow screw internal fixation.