摘要
目的探讨微创克氏针撬拔复位空心钉固定治疗难复位性股骨颈骨折疗效及可行性分析。方法回顾性分析2005年2月-2011年11月在该院行微创克氏针撬拔复位空心钉固定（n=46）及开放复位空心钉内固定（n=46）治疗难复位性股骨颈骨折92例患者的临床病例资料。比较分析不同内固定治疗的围手术及远期疗效。结果微机筛选微创克氏针撬拨复位空心钉固定与开放复位空心钉内固定治疗组患者在年龄、性别等基本资料无明显差异，具有可比性（P〉0．05）。所有患者获随访16-44个月，平均19．6个月，85例获临床愈合，愈合时间11-17周，平均16．3周。股骨头坏死7例，其中微创克氏针撬拔复位空心钉内固定治疗组1例，开放复位空心钉内固定治疗组6例，但两组无显著别。采用Garden指数评价股骨颈骨折复位质量，微创克氏针撬拨复位空心钉内固定治疗组46例患者均复位成功，骨折复位质量Ⅰ级38例，Ⅱ级7例，Ⅲ级1例但未见明显跛行；开放复位空心钉内固定治疗组46例患者均复位成功，骨折复位质量I级37例，Ⅱ级9例。根据Hams髋关节功能评分标准评价髋关节功能，微创克氏针撬拔复位空心钉内固定治疗组髋其中优良率93．5％（优35例，良8例，可2例，差1例），开放复位空心钉内固定治疗组优良率89．1％（优31例，良10例，可2例，差3例），统计分析结果显示微创克氏针撬拔复位空心钉内固定治疗较开放空心钉内固定治疗组有较好的长期疗效（P〈0．001）。结论微创克氏针撬拨复位空心钉内固定显示出独特的临床优势，是一种安全可行手术方式，值得临床推广。
[ Objective ] To explore safety and feasibility of minimally invasive closed reduction with percutaneous Kirschner wire and internal fixation with hollow compression screws for treatment of femoral neck fracture. [ Methods] From February 2005 to November 2011, 92 cases of femoral neck fracture patients in our hospital, including minimally invasive reduction with Kirschner wire （group 1, n =46） and open reduction （group 2, n =46）, was retrospectively analyzed. The perioperative and long-term postoperative outcome was comparative analysis. [Results] There was no significant difference of age, gender between two groups（P 〉0.05）. All of the patients were followed up for 16-44 months, an average of 19.6 months. 85 cases of chnieal healing, healing time 11-17 weeks, an average of 16.3 weeks. 7 cases of femoral head necrosis occurred, including one case in group 1 and 6 cases in open group, but there was no significance between the two groups. The healing quality of the femoral neck fractnrewas evaluated by Garden index, 46 cases in group 1 involving in 38 cases of level Ⅰ, 7 cases of level Ⅱ and 1 case of level Ⅲ were reduced successfully, but did not see obvious limp; 46 cases in group 2 involving in 37 cases of level Ⅰ and 9 cases of level Ⅱ were reduced successfully. 93.5% of patients in group 1 with excellent/good hip was evaluated by Harris standard, and group 2 was 89.1%. Statistical analysis results showedthat minimally invasive closed reduction with percutaneous Kirsehner wire and internal fixation with hollow compression screws for treatment of femoral neck fracture have better long-term efficacy （P 〈0.001）. [Conclusion] Minimally invasive closed reduction with pereutaneous Kirschner wire and internal fixation with hollow compression screws for treatment of femoral neck fracture is a safe and feasible operation, which owns unique clinical advantages, is worthy of clinical promotion.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2014年第16期68-71,共4页
China Journal of Modern Medicine
关键词
克氏针撬拨复位
空心钉内固定
股骨颈骨折
percutaneous closed reduction
internal fixation with hollow compression screws
femoral neck fracture
