[1]张于,程亮亮,王峰,等.2枚与3枚空心钉治疗无移位股骨颈骨折的疗效对比[J].中华老年骨科与康复电子杂志,2024,(05):281-286.[doi:10.3877/cma.j.issn.2096-0263.2024.05.004]
　Zhang Yu,Cheng Liangliang,Wang Feng,et al.Comparison of clinical efficacy between two versus three cannulated compression screws for the treatment of femoral neck fractures without displacement[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2024,(05):281-286.[doi:10.3877/cma.j.issn.2096-0263.2024.05.004]
点击复制

2枚与3枚空心钉治疗无移位股骨颈骨折的疗效对比()
分享到：

中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2024年05期
页码:
281-286
栏目:
髋部骨折
出版日期:
2024-10-05

文章信息/Info

Title:
Comparison of clinical efficacy between two versus three cannulated compression screws for the treatment of femoral neck fractures without displacement
作者:
张于; 程亮亮; 王峰; 赵德伟
116001 大连大学附属中山医院骨科
Author(s):
Zhang Yu;  Cheng Liangliang;  Wang Feng;  Zhao Dewei
Department of Orthopedics, Zhongshan Hospital, Dalian University, Dalian 116001, China
关键词:
股骨颈骨折;  空心钉;  无移位骨折
Keywords:
Femoral neck fractures;  Cannulated screws;  Fractures without displacement
DOI:
10.3877/cma.j.issn.2096-0263.2024.05.004
文献标志码:
A
摘要:
目的 比较运用2枚空心拉力螺钉与3枚空心拉力螺钉治疗无移位股骨颈骨折的临床疗效。方法 回顾性分析2017年1月至2020年12月期间我院采用空心钉内固定治疗的85例无移位股骨颈骨折患者资料。根据固定螺钉数量不同分为2枚空心拉力螺钉组及3枚空心拉力螺钉组。比较两组患者手术时间、术中出血量、骨折愈合时间，术后6个月髋关节评分及骨坏死、骨折不愈合等并发症。结果69例患者获得随访，2枚空心拉力螺钉组32例，随访时间（25.8±4.1）个月。男19例，女13例，平均年龄（48.71±12.6）岁，3枚空心拉力螺钉组37例，随访时间（27.9±5.2）个月。男21例，女16例，平均年龄（50.32±9.4）岁。2枚空心拉力螺钉组分别在手术时间（44.7±7.1）min、术中出血量（83.5±8.6）ml方面优于3枚空心拉力螺钉组（48.3±3.9）min及（88.6±7.9）ml，术后骨坏死发病率2枚空心拉力螺钉组（21.88%）显著低于3枚空心拉力螺钉组（35.14%），差异具有统计学意义（P＜0.001）；而在骨折愈合时间及髋关节评分方面无明显统计学差异。结论 对于GardenⅠ、Ⅱ型无移位股骨颈骨折，2枚空心拉力螺钉能够提供足够固定强度、早期进行功能康复，同时减少对股骨头内血运的破坏，显著降低术后骨坏死发生率。
Abstract:
Objective To compare the clinical efficacy of treating non-displaced femoral neck fractures with two versus three cannulated compression screws. Methods A retrospective analysis was conducted on 85 patients with non-displaced femoral neck fractures treated with cannulated screws in our hospital from January 2017 to December 2020. The patients were divided into two groups based on the number of fixation screws: the two-screw group and the three-screw group. The two groups were compared in terms of operation time, intraoperative blood loss, fracture healing time, hip joint scores at 6 months postoperatively, and complications such as osteonecrosis and nonunion. Results Sixty-nine patients were followed up; 32 in the two-screw group, with a follow-up period of 25.8±4.1 months. This group included 19 males and 13 females, with an average age of (46.3±10.1) years. The three-screw group comprised 37 patients, with a follow-up period of (27.9±5.2) months, including 21 males and 16 females, with an average age of (48.1±7.7) years. The two-screw group showed better results in operation time (44.7±7.1) minutes and intraoperative blood loss (83.5±8.6 ml) compared to the three-screw group (48.3±3.9) minutes and (88.6±7.9) ml, respectively. The incidence of postoperative osteonecrosis in the two-screw group (21.88%) was significantly lower than in the three-screw group (35.14%) (P<0.001). No significant statistical difference was observed in fracture healing time and hip joint scores. Conclusions For Garden I and II type non-displaced femoral neck fractures, two cannulated compression screws can provide sufficient fixation strength, allow early functional rehabilitation, and reduce the destruction of intraosseous blood supply to the femoral head, significantly lowering the rate of postoperative osteonecrosis.

相似文献/References:

[1]黄晓文,公茂琪,查晔军,等.早期快速闭合复位空心钉内固定治疗高龄股骨颈骨折的临床研究[J].中华老年骨科与康复电子杂志,2017,(01):4.[doi:10.3877/cma.j.issn.2096-0263.2017.01.002]
　Huang Xiaowen,Gong Maoqi,Zha Yejun,et al.Clinical results of early and rapid close reduction with internal fixation cannulated screws for femoral neck fractures in elderly patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(05):4.[doi:10.3877/cma.j.issn.2096-0263.2017.01.002]
[2]李涛,王英振,李玉龙,等.骨水泥与非骨水泥半髋关节置换治疗老年股骨颈骨折安全性的 Meta分析[J].中华老年骨科与康复电子杂志,2017,(02):109.[doi:10.3877/cma.j.issn.2096-0263.2017.02.008]
　Li Tao,Wang Yingzhen,Li Yulong,et al.Safety of cement and cementless hemiarthroplasty for femoral neck fractures in elderly patients: a meta- analysis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(05):109.[doi:10.3877/cma.j.issn.2096-0263.2017.02.008]
[3]李佳,刘勃,董天华,等.2010-2011年我国西南地区 11所医院 60岁以上股骨颈骨折患者的流行病学特征分析[J].中华老年骨科与康复电子杂志,2017,(02):116.[doi:10.3877/cma.j.issn.2096-0263.2017.02.010]
　Li Jia,Liu Bo,Dong Tianhua,et al.Epidemiological analysis of femoral neck fractures in patients over 60 years in Southwest China from 2010 to 2011[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(05):116.[doi:10.3877/cma.j.issn.2096-0263.2017.02.010]
[4]贾建波,禹宝庆,吴良浩,等.传统后路与微创 SuperPath入路的半髋置换治疗老年股骨颈骨折疗效比较[J].中华老年骨科与康复电子杂志,2017,(04):223.[doi:10.3877/cma.j.issn.2096-0263.2017.04.006]
　Jia Jianbo,Yu Baoqing,Wu Lianghao,et al.Hip hemiarthroplasty for senile femoral neck fractures: minimally invasive SuperPath approach versus traditional posterior approach[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(05):223.[doi:10.3877/cma.j.issn.2096-0263.2017.04.006]
[5]董天华,李石伦,于沂阳,等.中国南方和北方地区2010-2011年60岁以上人群股骨颈骨折流行病学对比[J].中华老年骨科与康复电子杂志,2017,(05):310.[doi:10.3877/cma.j.issn.2096-0263.2017.05.012]
　Dong Tianhua,Li Shilun,Yu Yiyang,et al.Epidemiological investigation of geriatric femoral neck fractures in south and north areas of China from 2010 to 2011[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(05):310.[doi:10.3877/cma.j.issn.2096-0263.2017.05.012]
[6]李佳,刘勃,刘松,等.中国中西部地区2010至2011年60岁以上股骨颈骨折流行病学对比[J].中华老年骨科与康复电子杂志,2018,(01):38.[doi:10.3877/cma.j.issn.2096-0263.2018.01.009]
　Li Jia,Liu Bo,Liu Song,et al.Epidemiological analysis of femoral neck fractures in patients over 60 years between middle and west areas of China from 2010 to 2011[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(05):38.[doi:10.3877/cma.j.issn.2096-0263.2018.01.009]
[7]范忠诚,曹亮,张寿,等.不同氨甲环酸应用方法对老年股骨头置换术引流量的影响[J].中华老年骨科与康复电子杂志,2018,(03):137.[doi:10.3877/cma.j.issn.2096-0263.2018.03.003]
　Fan Zhongcheng,Cao Liang,Zhang Shou,et al.Effect of tranexamic acid drainage method for elderly femoral head replacement[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(05):137.[doi:10.3877/cma.j.issn.2096-0263.2018.03.003]
[8]王沈栋,佘昶,董启榕.闭合复位空心螺钉治疗股骨颈骨折后股骨头坏死的影响因素分析[J].中华老年骨科与康复电子杂志,2019,(05):284.[doi:10.3877/cma.j.issn.2096-0263.2019.05.008]
　Wang Shendong,She Chang,Dong Qirong.Analysis of influencing factors related to femoral head necrosis after closed reduction and internal fixation with hollow screws[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2019,(05):284.[doi:10.3877/cma.j.issn.2096-0263.2019.05.008]
[9]焦力刚,张雷,王卫友.骨水泥型与非骨水泥型人工半髋关节置换术治疗高龄股骨颈骨折患者的对比研究[J].中华老年骨科与康复电子杂志,2020,(05):265.[doi:10.3877/cma.j.issn.2096-0263.2020.05.004]
　Jiao Ligang,Zhang Lei,Wang Weiyou..A comparative analysis of cemented and non cemented hemiarthroplasty in the treatment of femoral neck fracture in the elderly[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2020,(05):265.[doi:10.3877/cma.j.issn.2096-0263.2020.05.004]
[10]杜兵,马腾,路遥,等.新型股骨颈内固定系统与3枚空心钉加内侧钢板固定青壮年Pauwels Ⅲ型股骨颈骨折的有限元分析[J].中华老年骨科与康复电子杂志,2021,(06):333.[doi:10.3877/cma.j.issn.2096-0263.2021.06.003]
　Du Bing,Ma Teng,et al.Finite Element Analysis of the new femoral neck internal fixationsystem and three hollow screws plus medial plate fixation for Pauwels III femoral neck fractures in young adults[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2021,(05):333.[doi:10.3877/cma.j.issn.2096-0263.2021.06.003]
[11]周孝乾,田智勇,陈洪强,等.比基尼入路切开复位PFNA与闭合空心钉治疗青壮年股骨颈骨折的疗效比较[J].中华老年骨科与康复电子杂志,2020,(05):251.[doi:10.3877/cma.j.issn.2096-0263.2020.05.002]
　Zhou Xiaoqian,Tian Zhiyong,Chen Hongqiang,et al.Comparative Studies on the Use of PFNA associated with open reduction and cannulated screws with closed reduction in femoral neck fractures in young adults[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2020,(05):251.[doi:10.3877/cma.j.issn.2096-0263.2020.05.002]
[12]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.[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,(05):201.[doi:10.3877/cma.j.issn.2096-0263.2023.04.002]

备注/Memo

备注/Memo:
基金项目：大连市重点医学专业建设基金项目“登峰计划”
更新日期/Last Update: 2024-10-12