经皮加压空心螺钉内固定术对Graden Ⅱ型股骨颈骨折患者髋关节功能及躯体疼痛的影响

Effects of percutaneous compression hollow screw internal fixation on hip joint function and body pain in patients with GradenⅡfemoral neck fractures

目的 探讨不同内固定方式治疗GradenⅡ型股骨颈骨折患者对髋关节功能和躯体疼痛的影响。方法 选择2018年11月至2020年11月张家口市第二医院收治的GradenⅡ型股骨颈骨折患者230例,随机分为观察组120例和对照组110例;观察组采取经皮加压空心螺钉内固定术治疗,对照组采取经皮加压钢板内固定术治疗。观察两组患者手术治疗情况、术后康复情况、疗效和并发症发生情况。结果 观察组患者手术时间、术中出血量、住院时间低于对照组,Harris评分高于对照组[(90.53±6.88)分vs(82.09±7.68)分,t=8.793,P<0.01],术后开始下地时间和完全负重时间长于对照组,差异均有统计学意义(P<0.05)。两组骨折愈合时间比较差异无统计学意义(P>0.05)。术后3个月评价疗效,观察组和对照组优良率差异无统计学意义(96.67%vs 91.82%,χ^(2)=2.530,P>0.05)。观察组患者术后疼痛发生率低于对照组(2.50%vs 10.91%,χ^(2)=6.657,P<0.05),其他合并症发生率两组间差异无统计学意义(P>0.05)。结论 对GradenⅡ型股骨颈骨折的治疗,经皮加压空心螺钉内固定术在减少手术时长、术中出血量、住院时间及术后躯体疼痛方面较经皮加压钢板内固定术效果更好;而术后开始下地时间和完全负重时间方面后者更优;两种手术方式总体疗效相当。

Objective To explore the effects of different internal fixation methods on hip joint function and body pain in patients with GradenⅡfemoral neck fractures.Methods From November 2018 to November 2020,230 patients with GradeⅡfemoral neck fractures admitted to Zhangjiakou Second Hospital were randomly divided into observation group(n=120)and control group(n=110).Percutaneous compression hollow screw internal fixation was used in observation group,while percutaneous compression plate internal fixation was used in control group.The surgical treatment,postoperative rehabilitation,curative effect and complications of the two groups were observed.Results In observation group,the surgical time,intraoperative bleeding volume,and hospital stay were lower than those in control group,Harris score was higher than that in control group(90.53±6.88 vs 82.09±7.68,t=8.793,P<0.01),the time of getting out of bed and the time of fully weight-bearing after surgery were longer than those in control group(P<0.05).There was no statistically significant difference in fracture healing time between the two groups(P>0.05).The efficacy was evaluated 3 months after surgery,and there was no significant difference in the excellent and good rates between observation group and control group(96.67%vs 91.82%,χ^(2)=2.530,P>0.05).The incidence of postoperative pain in observation group was lower than that in control group(2.50%vs 10.91%,χ^(2)=6.657,P<0.05),and there was no significant difference in the incidence of other complications between two groups(P>0.05).Conclusion For the treatment of GradeⅡfemoral neck fractures,percutaneous compression hollow screw internal fixation is more effective than percutaneous compression plate internal fixation in reducing surgical duration,intraoperative bleeding,hospital stay,and postoperative body pain,while the latter is better in terms of postoperative time of getting out of bed and the time of fully weight-bearing after surgery,and the overall efficacy of the two surgical methods is equivalent.