摘要
目的:观察拉力螺钉联合交锁髓内钉内固定术治疗AO-C型股骨干骨折(FSF)患者的效果。方法:回顾性分析2018年5月至2019年6月该院收治的85例AO-C型FSF患者的临床资料,按照固定方式不同将其分为研究组43例、对照组42例。两组均进行内固定术治疗,对照组采用交锁髓内钉固定,研究组采用拉力螺钉联合交锁髓内钉固定。比较两组手术相关指标(术中出血量、手术时间、骨折愈合时间)水平,手术前后膝关节功能[美国特种外科医院膝关节(HSS)]评分、髋关节功能(Harris)评分,术后1年恢复优良率,手术前后疼痛程度[视觉模拟评分法(VAS)]评分、日常生活活动能力[日常生活活动能力量表(ADL)]评分,以及并发症发生率。结果:两组手术时间、术中出血量比较,差异均无统计学意义(P>0.05);研究组骨折愈合时间短于对照组,差异有统计学意义(P<0.05);术后6个月、1年,研究组HSS、Harris、ADL评分均高于对照组,VAS评分低于对照组,差异有统计学意义(P<0.05);研究组恢复优良率为95.35%(41/43),高于对照组的76.19%(32/42),差异有统计学意义(P<0.05);研究组并发症发生率为4.65%(2/43),低于对照组的21.43%(9/42),差异有统计学意义(P<0.05)。结论:拉力螺钉联合交锁髓内钉内固定术治疗AO-C型FSF患者可缩短骨折愈合时间,提高HSS、Harris、ADL评分和恢复优良率,降低VAS评分和并发症发生率,在手术时间、术中出血量方面与交锁髓内钉内固定术治疗效果相当。
Objective:To observe effects of lag screw combined with interlocking intramedullary nail internal fixation in treatment of AO-C type femoral shaft fractures(FSF).Methods:The clinical data of 85 patients with AO-C type FSF admitted to the hospital from May 2018 to June 2019 were retrospectively analyzed.According to different fixation methods,they were divided into study group(43 cases)and control group(42 cases).Both groups were treated with internal fixation.The control group was fixed with interlocking intramedullary nail,while the study group was fixed with lag screw combined with interlocking intramedullary nail.The operation related index levels(intraoperative blood loss,operation time,fracture healing time),the knee joint function[hospital for special surgery(HSS)]score,the hip joint function(Harris)score before and after the operation,the excellent and good rate of recovery 1 year after the operation,the pain degree[visual analogue scale(VAS)]score before and after the operation,the activities of daily living[activity of daily living scale(ADL)]score,and the incidence of complications were compared between the two groups.Results:There were no significant differences in the operation time and the intraoperative blood loss between the two groups(P>0.05).The fracture healing time of the study group was shorter than that of the control group,and the difference was statistically significant(P<0.05).6 months and 1 year after the operation,the HSS,Harris and ADL scores of the study group were higher than those of the control group,the VAS score was lower than that of the control group,and the differences were statistically significant(P<0.05).The excellent and good rate of recovery in the study group was 95.35%(41/43),which was higher than 76.19%(32/42)in the control group,and the difference was statistically significant(P<0.05).Further,the incidence of complications in the study group was 4.65%(2/43),which was lower than 21.43%(9/42)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Lag screw combined with interlocking intramedullary nail internal fixation in the treatment of the AO-C type FSF patients can shorten the fracture healing time,improve the HSS,Harris and ADL scores and the excellent and good rate of recovery,and reduce the VAS score and the incidence of complications.The operation time and the intraoperative blood loss were comparable to those of interlocking intramedullary nail internal fixation.
作者
李冰
LI Bing(Emergency Department of Xuchang Central Hospital Affiliated to Henan University of Science and Technology,Xuchang 461000 Henan,China)
出处
《中国民康医学》
2023年第9期63-66,共4页
Medical Journal of Chinese People’s Health
关键词
拉力螺钉
交锁髓内钉
AO-C型股骨干骨折
疼痛
膝关节功能
髋关节功能
并发症
Lag screw
Interlocking intramedullary nail
AO-C type femoral shaft fracture
Pain
Knee joint function
Hip function
Complication
