摘要
背景:对于年轻股骨颈骨折的患者,螺钉内固定治疗是其主要的治疗方式,如何减少创伤,保护好创伤部位的局部血运,降低术后并发症是学者们共同关心的热点。目的:观察经皮微创加压空心螺钉内固定修复年轻股骨颈骨折的疗效及其对双下肢长度和髋关节功能的影响。方法:回顾性分析复旦大学附属上海市浦东医院2009年1月至2012年12月收治的股骨颈骨折患者30例,采用牵引床下透视闭合复位经皮微创加压空心螺钉内固定治疗,作为经皮微创组;选择2006年1月至2009年12月收治的股骨颈骨折患者28例,采用切开复位股方肌骨瓣移植加压空心螺钉内固定治疗,作为肌骨瓣移植组。观察2组的疗效、术中失血量、手术时间、住院时间、骨折愈合时间和并发症发生率,比较术后3个月和1年双下肢长度差和髋关节功能评分。结果与结论:(1)2组患者均获得随访,时间24-60个月;(2)经皮微创组优良率为90%,肌骨瓣移植组为93%,2组差异无显著性意义(χ~2=0.007,P>0.05);(3)经皮微创组的术中失血量、手术时间、住院时间明显少于肌骨瓣移植组(P<0.01),而2组的骨折愈合时间、并发症发生率及术后3个月、1年双下肢长度差和髋关节功能评分差异无显著性意义(P>0.01);(4)结果提示,牵引床下经皮微创加压空心螺钉内固定修复年轻股骨颈骨折疗效确切,闭合复位满意,创伤小,术后恢复快,适用于各型年轻股骨颈骨折。
BACKGROUND： Screw fixation is mainly used in the treatment of femoral neck fractures in the youth; therefore, how to reduce surgical trauma, retain sufficient blood supply and reduce postoperative complications becomes so important. OBJECTIVE： To study the efficacy of minimal invasive percutaneous fixation with cannulated compression screws for young patients with femoral neck fracture and its impact on the length of bilateral lower limbs and hip joint function. METHODS： Thirty patients with femoral neck fracture admitted in the Shanghai Pudong Hospital Affiliated to Fudan University from January 2009 to December 2012, were selected as experimental group, followed by subjected to minimal invasive percutaneous traction bed-assisted closed reduction with cannulated compression screws. Meanwhile, 28 cases of femoral neck fracture admitted from January 2006 to December 2009, were given open reduction with square muscle grafting and cannulated screw fixation （control group）. The efficacy, intraoperative blood loss, operation time, hospital stay, fracture healing time and incidence of complications were observed. Additionally, the length of bilateral lower limbs and Harris hip scores at 3 months and 1 year postoperatively were compared between two groups. RESULTS AND CONCLUSION： （1） All patients were followed up for 24-60 months. （2） The excellent and good rate in the experimental and control groups was 90% and 93%, respectively, which showed no significant difference between two groups （χ2=0.007, P 〉 0.05）. （3） The intraoperative blood loss, operation time, and hospital stay in the experimental group were significantly less than those in the control group （P 〈 0.01）; while, the fracture healing time, incidence of complications as well as length of bilateral lower limbs and Harris hip scores at 3 months and 1 year postoperatively did not differ significantly between two groups （P 〉 0.01）. （4） These results suggest that the minimal invasive percutaneous fixation with cannulated compression screws applied in the treatment of young patients with femoral neck fracture exhibits satisfactory efficacy, good reduction, less trauma and rapid postoperative recovery, which is available for all types of young femoral neck fracture.
出处
《中国组织工程研究》
CAS
北大核心
2017年第35期5649-5654,共6页
Chinese Journal of Tissue Engineering Research
基金
上海市浦东新区卫生系统领先人才培养计划资助项目(PWR12013-01)~~
