摘要
背景:Pauwels Ⅲ型股骨颈骨折是一种极不稳定的股骨颈骨折,目前临床上针对该类型骨折主要采用加压空心螺钉及动力髋螺钉(DHS)两种内固定方式治疗,但其临床效果尚存争议。目的的:分析对比加压空心螺纹钉和动力髋螺钉(DHS)治疗Pauwels Ⅲ型股骨颈骨折的临床疗效。方法法:回顾性分析2010年1月至2015年9月我院收治的Pauwels Ⅲ型股骨颈骨折患者的临床资料,选取加压空心螺纹钉固定组60例,DHS固定组60例,两组患者一般资料具有可比性(P>0.05)。对比两组患者的手术时间、术中出血量等手术指标,术后退钉及内固定失效、股骨头坏死并发症的发生率,Harris评分等临床疗效评价指标。结果结果:加压空心螺纹钉固定组的手术时间短、术中出血量少,明显优于DHS固定组(P<0.05)。DHS固定组的术后Harris评分明显优于加压空心螺纹钉固定组(P<0.05)。加压空心螺纹钉固定组退钉6例(退钉率10%),股骨头坏死4例(股骨头坏死率6.67%),显著高于DHS固定组(P<0.05)。结论结论:对于Pauwels Ⅲ型股骨颈骨折患者,行DHS固定比加压空心螺纹钉效果好,术后并发症少、关节恢复效果佳。
Background： Pauwels Ⅲ femoral neck fracture is an extremely unstable fracture. Two methods, cannulated com- pression screws and dynamic hip screws （DHS） are usually used for it, but their clinical outcomes are controversial. Objective： To compare the clinical outcome between cannulated compression screws and dynamic hip screws for Pauwels Ⅲ femoral neck fracture. Methods： Clinical data of the patients with Pauwels Ⅲ femoral neck fracture treated in our hospital between January 2010 and September 2015 were retrospectively analyzed in this study. Cannulated compression screws were used in 60 patients and DHS were applied in another 60 ones. Operation time, intraoperative blood loss, incidence of postoperative screw loosening, internal fixation failure, femoral head necrosis and Harris hip score were compared between two groups. Results： The operation time and intraoperative blood loss in the cannulated compression screw group were significantly less than those in the DHS group （P〈0.05）. The Harris hip score in the DHS group was significantly higher than that in the can- nulated compression screw group （P〈0.05）. The incidence of screw loosening and femoral head necrosis were 10% （6 cas- es） and 6.67% （4 cases） in the cannulated compression screw group, which were significantly higher than those in the DHS group （P〈0.05）. Conclusions： DHS fixation is a better treatment for Pauwels IU femoral neck fracture when compared with cannulated compression screws, which has less postoperative complications and better hip joint function.
出处
《中国骨与关节外科》
2016年第5期414-417,共4页
Chinese Journal of Bone and Joint Surgery
关键词
内固定器
股骨颈骨折
Internal Fixators
Femoral Neck Fractures
