股骨颈动力抗旋交叉钉与空心螺钉固定对股骨颈骨折患者骨折复位质量的影响对比

Comparison of FNS and Hollow Screw Fixation on Fracture Reduction Quality in Patients with Femoral Neck Fracture

目的:探讨股骨颈动力抗旋交叉钉系统(FNS)与空心螺钉固定对股骨颈骨折患者骨折复位质量的影响。方法:选取本院骨科2019年1月—2022年1月收治的股骨颈骨折患者78例作为研究对象,根据治疗方法分成FNS组和空心螺钉固定组,各39例。比较两组股骨近端应力分布及峰值、不同载荷下的综合位移指数(Pauwels角30°、50°、70°)、髋关节功能Harris评分、Garden指数差异。结果:(1)Pauwels角30°、50°、70°时,FNS组股骨近端应力峰值低于空心螺钉固定组,内固定装置应力峰值高于空心螺钉固定组,股骨近端最大位移峰值显著低于空心螺钉固定组,内固定最大位移峰值低于空心螺钉固定组(P<0.05)。(2)Pauwels角30°、50°、70°时,FNS组300、600、900、1200N载荷值均低于空心螺钉固定组(P<0.05)。(3)FNS组髋关节功能Harris评分高于空心螺钉固定组(P<0.05)。(4)FNS组Ⅱ级复位率较空心螺钉固定组更高,Ⅲ、Ⅳ级复位率较空心螺钉固定组更低(P<0.05)。结论:对于股骨颈骨折患者的骨折复位质量而言,采用FNS治疗的生物力学稳定性较空心螺钉更好,内固定失效率较空心螺钉更低。

Objective:To investigate the effect of internal femoral neck system(FNS)and hollow screw fixation on the fracture reduction quality of femoral neck fractures patients.Methods:78 femoral neck fractures patients admitted from January 2019 to January 2022 were selected as the study subjects and divided into FNS and hollow screw fixation groups according to the treatment method,with 39 cases each.Stress distribution and peak of proximal femur between the two groups,comprehensive displacement index(Pauwels angle 30°,50°,70°),Harris score of hip function and Garden index between the two groups.Results:(1)Pauwels angles 30°,50°and 70°,the peak proximal femoral stress in the FNS group was lower than the hollow screw fixation group,the peak internal fixation stress was higher than the hollow screw fixation group,the maximum proximal femoral displacement was significantly lower than the hollow screw fixation group,and the maximum internal displacement was lower than the hollow screw fixation group(P<0.05).(2)Pauwels angles 30°,50°,70°,the FNS group 300,600,900 and 1200N were lower than the hollow screw fixation(P<0.05).(3)The Harris score of hip function in the FNS group was higher than in the hollow screw fixation group(P<0.05).(4)TheⅡgrade reduction rate in the FNS group was higher than the hollow screw fixation group,and the reduction rate ofⅢ~Ⅳgrade was lower than that of hollow screw fixation group(P<0.05).Conclusion:For femoral neck fractures patients,FNS has better biomechanical stability and lower internal fixation efficiency than hollow screws.