| 崔伟宾,刘永亮.切开复位空心钉内固定联合带血管蒂骨瓣移植治疗GardenⅢ和Ⅳ型股骨颈骨折疗效分析[J].中国烧伤创疡杂志,2023,(5):392~395. |
| DOI： |
| 中文关键词: 切开复位空心钉内固定 闭合复位空心钉内固定 带血管蒂骨瓣移植 股骨颈骨折 髋关节功能 |
| 英文关键词:Open reduction and cannulated screw internal fixation Closed reduction and cannulated screw internal fixation Vascular-pedicled bone grafting Femoral neck fracture Function of hip joint |
| 基金项目: |
|
| 摘要点击次数: 1384 |
| 全文下载次数: 4315 |
| 中文摘要: |
| 【摘要】 目的 探究切开复位空心钉内固定联合带血管蒂骨瓣移植治疗 Garden Ⅲ和Ⅳ型股骨颈骨折的临床疗效? 方法 选取 2019 年 1 月至 2020 年 7 月郑州经济技术开发区九龙医院收治的92例 GardenⅢ和Ⅳ型股骨颈骨折患者作为研究对象, 根据不同手术方式将其分为观察组(46例)与对照组 (46例), 观察组患者于患肢肿胀基本消除后行切开复位空心钉内固定联合带血管蒂骨瓣移植治疗, 对照组患者于患肢肿胀基本消除后行闭合复位空心钉内固定治疗, 对比观察两组患者术后负重行走时间、骨折复位质量、髋关节功能及并发症发生情况? 结果 观察组患者术后负重行走时间明显短于对照组 (t = 3.173, P = 0.002); 术后12周, 观察组患者骨折复位质量为Ⅰ级36例、Ⅱ级 8 例、Ⅲ级 1 例、Ⅳ级 1 例, 明显优于对照组患者的骨折复位质量为Ⅰ级 24 例、Ⅱ级 12例、Ⅲ级 6 例、Ⅳ级 4 例 (Z = - 2.804, P = 0.005); 术后3、6、12个月, 观察组患者Harris评分均明显高于对照组 (t = 3.481、3.443、4.778, P 均< 0.001); 术后随访12个月, 观察组患者并发症发生率为 4.35% , 明显低于对照组患者的并发症发生率 17.39% (χ2= 4.039, P = 0.044)? 结论 切开复位空心钉内固定联合带血管蒂骨瓣移植治疗 Garden Ⅲ和Ⅳ型股骨颈骨折, 可明显改善骨折复位质量, 提高髋关节功能恢复效果, 降低并发症发生风险? |
| 英文摘要: |
| 【Abstract】 Objective To analyze the clinical efficacy of open reduction and cannulated screw internal fixation combined with vascular-pedicled bone grafting in the treatment of femoral neck fracture of Garden stage Ⅲ and Ⅳ. Methods 92 patients with femoral neck fracture of Garden stage Ⅲ and Ⅳ admitted into Zhengzhou Economic and Technological Development Zone Jiulong Hospital between January 2019 and July 2020 were enrolled as research subjects, and divided into study group (n = 46) and control group (n = 46) based on different surgical methods they received. When the swellingof the affected limbs was basically subsided, patients in the study group were treated with the open reduction and cannulated screw internal fixation plus vascular-pedicled bone grafting, while patients were treated with the closed reduction and cannu-lated screw internal fixation in the control group. The time of postoperative weight-bearing walking, reduction quality of fracture, functions of hip joint and occurrence of complications of patients were compared between the two groups. Results The time of postoperative weight-bearing walking of patients was obviously shorter in the study group compared with the control group (t = 3.173, P = 0.002). 12 weeks after surgery, the reduction quality of fracture was evaluated as grade Ⅰ in 36 cases, grade Ⅱ in 8 cases, grade Ⅲ in 1 case and grade Ⅳ in 1 case in the study group, which was obviously better than that in the control group (Z = - 2.804, P = 0.005) - grade Ⅰ in 24 cases, grade Ⅱ in 12 cases, grade Ⅲ in 6 cases and grade Ⅳ in 4 cases. Respectively on month 3, 6 and 12 after surgery, the Harris scores of patients in the study group were all markedly higher than that in the control group (t = 3.481, 3.443 and 4.778, all P < 0.001). During the follow-up 12 months after surgery, the incidence of complications was 4.35% in the study group, being significantly lower than the corresponding 17.39% in the control group ( χ2= 4.039, P = 0.044). Conclusion In the treatment of femoral neck fracture of Garden stage Ⅲ and Ⅳ, the open reduction and cannulated screw internal fixation plus vascular-pedicled bone grafting can significantly improve the reduction quality of fracture and the restoration of hip joint functions, and reduce the risk of complications. |
|
|
|
|
