| 摘要: |
| 目的 探讨股骨颈动力交叉钉系统治疗中青年PauwelsⅡ~Ⅲ型股骨颈骨折的疗效。方法 回顾性分析13例接受股骨颈动力交叉钉系统治疗的中青年PauwelsⅡ~Ⅲ型股骨颈骨折患者的临床资料。13例患者中男8例、女5例，年龄为（50.9±14.1）岁，骨折Pauwels分型Ⅱ型4例、Ⅲ型9例。对患者术前、术后的髋关节Harris评分、Barthel指数评分、疼痛视觉模拟量表（VAS）评分进行比较。结果 13例患者的手术时间为（52.08±11.54）min，术中出血量为（68.8±20.4）mL，术中透视次数为（12.8±2.2）次，住院时间为（5.8±1.7）d。以Garden对线指数评估骨折复位质量，Ⅰ级8例、Ⅱ级5例。骨折愈合时间为（4.0±0.7）周。2例（15.4%）并发股骨颈短缩（轻度1例、中度1例），无并发下肢静脉血栓的患者。术后部分负重时间为（4.1±1.0）周，完全负重时间为（7.2±0.9）周。术后6个月髋关节Harris评分为89.46±4.35、Barthel指数评分为79.92±22.17、VAS评分为0.69±0.75，术后12个月上述指标分别为90.77±3.37、91.31±3.82、0.62±0.65，与术前（18.08±6.70、23.38±7.07、8.08±1.32）比较均明显改善（P均<0.01）。结论 股骨颈动力交叉钉系统治疗中青年PauwelsⅡ~Ⅲ型股骨颈骨折疗效良好，且有创伤小、骨折块愈合好、并发症少等优点。 |
| 关键词: 股骨颈骨折 骨折固定术 股骨颈动力交叉钉系统 治疗结果 |
| DOI：10.16781/j.CN31-2187/R.20230338 |
| 投稿时间：2023-06-16修订日期：2023-09-06 |
| 基金项目:海南省卫生健康行业科研项目（19A200123，20A200518），海南省科技专项资助项目（ZDYF2020122）. |
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| Efficacy of femoral neck system on young and middle-aged patients with Pauwels Ⅱ-Ⅲ femoral neck fractures |
| FAN Zhongcheng,WAN Dadi,TU Yuanyuan,WANG Qunli* |
(Department of Orthopaedics, Haikou Hospital for Orthopaedics and Diabetes, Shanghai Sixth People's Hospital, Haikou 570300, Hainan, China
*Corresponding author) |
| Abstract: |
| Objective To explore the efficacy of femoral neck system (FNS) in the treatment of Pauwels Ⅱ-Ⅲ femoral neck fractures in young and middle-aged patients. Methods The clinical data of 13 young and middle-aged patients with femoral neck fractures undergoing FNS treatment were retrospectively analyzed. There were 8 males and 5 females, with an age of (50.9±14.1) years. The Pauwels of fractures were type Ⅱ in 4 cases and type Ⅲ in 9 cases. Preoperative and postoperative Harris hip score, Barthel index score and visual analogue scale (VAS) score were compared. Results The operative time of the 13 patients was (52.08±11.54) min, intraoperative blood loss was (68.8±20.4) mL, intraoperative fluoroscopy was (12.8±2.2) times, and hospital stay was (5.8±1.7) d. The Garden alignment index was used to evaluate the quality of fracture reduction. There were 8 cases of grade Ⅰ and 5 cases of grade Ⅱ. The fracture healing time was (4.0±0.7) weeks. Two cases (15.4%) were complicated with femoral neck shortening (1 mild, 1 moderate), and no concurrent lower limb venous thrombosis was found. The postoperative partial weight-bearing time was (4.1±1.0) weeks, and complete weight-bearing time was (7.2±0.9) weeks. The Harris hip score was 89.46±4.35, Barthel index score was 79.92±22.17, and VAS score was 0.69±0.75 at 6 months after surgery; at 12 months after surgery, the above indicators were 90.77±3.37, 91.31±3.82, and 0.62±0.65, respectively, which were significantly improved compared with those before operation (18.08±6.70, 23.38±7.07, and 8.08±1.32) (all P<0.01). Conclusion FNS is effective in the treatment of young and middle-aged patients with PauwelsⅡ-Ⅲ femoral neck fractures. It has the advantages of less trauma, good healing of fracture block and fewer complications. |
| Key words: femoral neck fractures fracture fixation femoral neck system outcomes |
