摘要
目的：探讨经皮加压钢板（PCCP）内固定治疗与3枚空心加压螺钉内固定治疗中青年股骨颈骨折的疗效。方法：480例患者随机分为两组，观察组240例，行PCCP内固定治疗；对照组240例，行3枚空心加压螺钉内固定治疗。观察两组患者的手术时间、术中出血量、术后住院时间、术前后血红蛋白差值、骨折复位质量、术后部分负重时间、完全负重时间，以及骨折愈合情况以及愈合时间、并发症，测量髋关节功能、视觉模拟评分（visual analogue scale，VAS）。结果：（1）观察组术后并发症的发生率（5.0%）明显低于对照组（27.9%），差异有统计学意义（χ^2=45.84，P〈0.01）。（2）两组患者的手术时间、术后住院时间、术中出血量、术前后血红蛋白差值、骨折愈合时间、骨折复位质量及末次随访时髋关节功能比较差异均无统计学意义（P〉0.05）。观察组患者的术后部分负重时间[（5.1±2.0） vs （89.4±32.5）d]、完全负重时间[（2.1±1.5） vs （6.9±4.4） d]均低于对照组，术后3个月髋关节功能优于对照组（P〈0.05）。（3）观察组第1天[（7.1±2.3） vs （8.3±2.9）分]、第1周[（6.4±1.8） vs （7.6±2.5）分]的VAS评分低于对照组（P〈0.05）。结论：对于治疗中青年股骨颈骨折，与3枚空心加压螺钉相比，PCCP具有创伤小的优点，且PCCP内固定更牢固，疼痛缓解更明显，术后并发症发生率低。
Objective：To investigate the differential efficacies between percutaneous compression plating （PCCP） and 3 cannulated-compression screws on non-older patients with femoral neck fractures.Method：A total of 480 cases of femoral neck fractures were randomly divided into observer group （240 cases,PCCP） and control group （240 cases,3 cannulated-compression screws）.The operative time,intraoperatve blood soss, post-operation hospitalization duration,the difference value of pre- and post-operative hemoglobin,reduction of fracture,post-operative part and whole load time,fracture healing status and time,complication,hip-joint function, and visual analogue scale （VAS） were measured.Result：（1）The rate of complications in observer group （5.0%） was lower than that in control group （27.9%）（ χ^2=45.84,P〈0.01）.（2）There were no differences in operative time,post-operation hospitalization duration,intraoperatve blood soss, the difference value of pre- and post-operative hemoglobin,fracture healing status and time,and last follow-up hip-joint function between two groups（P〉0.05）.The post-operative part [（5.1±2.0） vs （89.4±32.5） d] and whole load times [（2.1±1.5） vs （6.9±4.4） d] in observer group were lower than those in control group,hip-joint function after operation 3 months was better than that in control group（P〈0.05）.（3）The scores of VAS post-operative 1 d [（7.1±2.3） vs （8.3±2.9）],and 1 week [（6.4±1.8） vs （7.6±2.5）] in observer group were lower than those in control group（P〈0.05）.Conclusion：PKP is effective in the treatment of old osteoporotic vertebral compression fractures combined with intravertebral clefts.It can relieve pain rapidly and effectively, correct kyphosis,and prevent vertebra collapse.When the patients with osteoporotic vertebral old compression fractures combined with intravertebral clefts were treated by PKP,it could rapidly relieve the pain and recover the height of vertebral. PKP could be considered as an effective treatment.To treat non-older patients with femoral neck fractures, PCCP has low trauma,a good internal fixation, significant pain relief,and low rate of complications compared to 3 cannulated-compression screws therapy.
出处
《中国医学创新》
CAS
2016年第20期39-43,共5页
Medical Innovation of China
基金
国家自然科学基金(1400070178)
关键词
股骨颈骨折
非老年人
经皮加压钢板
空心加压螺钉
Femoral neck fractures
Non-older patients
Percutaneous compression plating
Cannulated compression screw
