[1]宋晓亮,郝海虎,刘渊,等.股骨重建钉治疗股骨颈骨折的疗效观察[J].中华老年骨科与康复电子杂志,2023,(04):201-208.[doi:10.3877/cma.j.issn.2096-0263.2023.04.002]
　Song Xiaoliang,Hao Haihu,Liu Yuan,et al.Application of femoral reconstructing nail in the treatment of femoral neck fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2023,(04):201-208.[doi:10.3877/cma.j.issn.2096-0263.2023.04.002]
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股骨重建钉治疗股骨颈骨折的疗效观察()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2023年04期
页码:
201-208
栏目:
股骨骨折
出版日期:
2023-08-05

文章信息/Info

Title:
Application of femoral reconstructing nail in the treatment of femoral neck fractures
作者:
宋晓亮1; 郝海虎2; 刘渊3; 李浩江1; 雷晓晶1; 邵新中4; 李卿源5
046000 山西省长治市第二人民医院创伤骨科1；030000 太原，山西白求恩医院创伤骨科2；056000 邯郸市第一医院创伤骨科3；050011 石家庄，河北医科大学第三医院手外科4；300220 天津医院手显微外科一病区5
Author(s):
Song Xiaoliang1;  Hao Haihu2;  Liu Yuan3;  Li Haojiang1;  Lei Xiaojing1;  Shao Xinzhong4;  Li Qingyuan5.
1Department of Trauma Orthopaedics, Changzhi Second People’s Hospital, Changzhi 046000, China; 2Department of Trauma Orthopaedics, Shanxi Norman Bethune Hospital, Taiyuan 030000, China; 3Department of Trauma Orthopaedics, Handan First Hospital, Handan 056000, China; 4Department of Hand Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang 050011, China; 5Department of Hand Microsurgery, Tianjin Hospital, Tianjin 300220, China
关键词:
股骨颈骨折;  股骨重建钉;  空心钉;  股骨头坏死;  股骨颈短缩
Keywords:
Femoral neck fracture;  Femoral reconstruction nail;  Cannulate compression screw;  Femoral head necrosis;  Femoral neck shortening
DOI:
10.3877/cma.j.issn.2096-0263.2023.04.002
文献标志码:
A
摘要:
目的 观察分析使用股骨重建钉治疗股骨颈骨折的临床效果。方法 回顾性分析了长治市二院自2018年1月至2021年12月期间采用股骨重建钉治疗股骨颈骨折患者的临床资料，并与同期采用倒三角空心钉固定的患者进行对比。主要评价指标有两组患者的手术时间、出血量、术后2 d VAS评分、术后早期并发症及术后开始部分负重时间，并采用Harris 评分评价髋关节功能。另外对患者骨折复位、愈合情况及股骨颈短缩程度进行评估。结果 45例患者均获随访，随访时间9～18个月，平均（13.0±3.1）月。其中男27例，女18例，年龄从18～75岁。重建钉组患者手术时间及出血量分别为（82.7±16.2）min、35.00（30.00，50.00）ml均多于空心钉组的（64.0±18.2）min、17.50（13.75，30.00）ml（P＜0.05）；术后 2 d VAS 评分重建钉组[2.00（1.00，2.00）分]与空心钉组[2.00（1.00，2.00）分]无差异。空心钉组开始部分负重时间[8.00（6.00，10.00）周]，晚于重建钉组[2.00（2.00，3.00）周]（P＜0.05）。髋关节Harris评分重建钉组[94.00（88.00，98.00）分]高于空心钉组[84.00（71.75，91.00）分]（P＜0.05）。术后定期复查X线片，空心钉组1例患者在随访期内未愈合，1例螺钉切出，1例未愈合并有股骨头坏死。重建钉组1例患者未愈合合并股骨头坏死。空心钉组骨折愈合时间[9.00（7.00，10.00）个月]与重建钉组[8.00（7.00，8.00）个月]无差异。空心钉组股骨颈短缩长度[4.00（2.00，7.00）mm]长于重建钉组 [1.00（0.00，2.00）mm]，（P＜0.05）。结论 使用股骨重建钉固定股骨颈骨折具有明显的临床优势，如可早期负重、股骨颈短缩程度轻、髋关节功能好等，且股骨重建钉的临床应用时间长、技术成熟，易于推广。
Abstract:
Objective To investigate the clinical effect of femoral reconstruction nail in the treatment of femoral neck fractures. Methods A retrospective analysis was performed on 45 patients with femoral neck fractures in our hospital from January 2018 to Decemberr 2021.There were 30 patients in the CCS group and 15 patients in the femoral reconstruction nail group, with range 18 to 75 years.The main evaluation indicators for both groups of patients include surgical time, bleeding volume, VAS score at 2 days after surgery, early postoperative complications, and time to start partial weight-bearing after surgery, Harris score of the hip joint, fracture reduction, healing status, and degree of femoral neck shortening. Results 45patients were followed up for 9 to 18 months, mean (13.0±3.1) months. There were 27 males and 18 females, with range 18 to 75. Both groups showed the average operation time was [(64±18.2) vs (82.7±16.2) min,?P<0.05], the median bleeding volume was [17.50 (13.75, 30.00) vs 35.00(30.00, 50.00)ml, P<0.001], the median VAS score at 2 days after surgery was [2.00(1.00, 2.00) vs 2.00(1.00, 2.00), P=0.227], the median postoperative partial weight-bearing time was [8.00(6.00, 10.00) vs 2.00(2.00, 3.00) weeks，P<0.001], the median hip joint Harrisscore was [84.00(71.75, 91.00) vs 94.00(88.00, 98.00), P<0.05], the median fracture healing time was [9.00(7.00, 10.00) vs 8.00(7.00, 8.00) months, P=0.075], the median femoral neck shortening length was [4.00(2.00, 7.00) vs 1.00(0.00, 2.00)mm, P<0.001]. Among them, a patient in the CCS group did not heal during the follow-up period, a patient had screw penetration, and a patient did not heal with femoral head necrosis. A patient in the femoral reconstruction nail group did not heal with femoral head necrosis. Conclusion The fixation of femoral neck fractures with femoral reconstruction nails has significant clinical advantages, such as early weight bearing, mild shortening of the femoral neck, and good hip joint function.In addition, femoral reconstruction nails are a mature technology that has a long clinical application time and is easy to promote.

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备注/Memo

备注/Memo:
基金项目：山西省科技厅自然科学研究面上项目（202103021224347）
更新日期/Last Update: 2023-09-01