| 罗天放,王 明,郑耀鹏.FNS 固定与 CCS 固定治疗中青年股骨颈骨折疗效对比[J].中国烧伤创疡杂志,2024,(1):44~48. |
| DOI： |
| 中文关键词: 股骨颈动力交叉钉系统 空心加压螺钉 中青年 股骨颈骨折 髋关节功能 日常生活能力 |
| 英文关键词:Femoral neck system Cannulated compression screw Young and middle-aged Femoral neck
fracture Hip joint function Activities of daily living |
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| 中文摘要: |
| 【摘要】 目的 对比分析股骨颈动力交叉钉系统 (FNS) 固定与空心加压螺钉 (CCS) 固定治疗中青年股骨颈骨折的临床疗效。方法 选取 2019 年 4 月至 2021 年 4 月新郑华信民生医院收治的 140 例中青年股骨颈骨折患者作为研究对象, 按照不同治疗方法将其分为 FNS 组 (67例)和CCS组 (73例), FNS 组患者行FNS固定治疗, CCS 组患者行 CCS 固定治疗, 对比观察两组患者术中出血量、术中透视次数、手术时间、住院时间、术后完全负重开始时间等手术相关情况与骨折愈合情况, 以及疼痛程度、股骨颈短缩长度、日常生活能力、髋关节功能与不良事件发生情况。结果 FNS 组患者术中出血量和住院时间与 CCS 组无明显差异 ( t = 1.379、0.411, P =0.170、0.682), 术中透视次数明显少于 CCS 组 (t = 12.682, P<0.001), 手术时间、术后完全负重开始时间及骨折愈合时间均明显短于 CCS 组 (t = 8.789、8.418、8.177, P 均<0.001); 术后6个月, FNS 组患者视觉模拟评分法 (VAS) 评分明显低于 CCS 组 ( t = 6.835, P< 0.001), 股骨颈短缩长度明显短于 CCS 组 ( t = 10.252, P<0.001), Barthel 指数评分与 Harris 评分均明显高于CCS组 ( t = 8.158、11.051, P均<0.001)。FNS 组患者术后不良事件发生率为 8.96%, 明显低于CCS组患者的术后不良事件发生率 24.66% ( χ2 = 6.064, P= 0.014)。结论 与CCS固定相比, FNS固定更能明显减少中青年股骨颈骨折患者术中透视次数, 缩短手术时间、术后完全负重开始时间和骨折愈合时间, 减轻患者疼痛及股骨颈短缩程度, 促进髋关节功能恢复, 提高患者日常生活能力,降低术后不良事件发生风险, 临床应用价值更高。 |
| 英文摘要: |
| 【Abstract】 Objective To compare the clinical efficacy of femoral neck system ( FNS) fixation and cannulated compression screw (CCS) fixation in young and middle-aged patients with femoral neck fractures. Methods 140 young and middle-aged patients with femoral neck fractures, admitted to Hopeshine Minsheng Hospital of Xinzheng from April 2019 to April 2021, were enrolled into the study and divided into FNS group (n = 67), receiving FNS fixation, and CCS group (n =73), receiving CCS fixation, and the following items were compared between the two groups, including surgery-related indicators, i.e., intraoperative blood loss volume, times of intraoperative fluoroscopy, operation time, length of stay, postoperative full weight-bearing start time, as well as fracture healing condition, pain intensity, shortened length of femoral neck,activities of daily living, hip joint function, and occurrences of postoperative adverse events. Results There were no significant differences between the FNS group and the CCS group in terms of intraoperative blood loss volume and length of stay(t = 1.379 and 0.411, P= 0.170 and 0.682) .The times of intraoperative fluoroscopy in the FNS group were significantly less than that in the CCS group (t = 12.682, P<0.001), and the operation time and fracture healing time were significantly shorter (t=8.789 and 8.418, both P<0.001), and the postoperative full weight-bearing start time was notably earlier (t =8.177, P<0.001) in the FNS group. Six months after surgery, the visual analogue scale (VAS) scores were significantly lower (t=6.835, P<0.001), and the shortened length of femoral neck was significantly less ( t =10.252, P<0.001) in the FNS group compared with the CCS group. Additionally, both Barthel index scores and Harris scores were significantly higher in the FNS group (t=8.158 and 11.051, both P<0.001). The incidence of postoperative adverse events was 8.96% in the FNS group, being significantly lower than 24.66% in the CCS group (χ2 = 6.064, P= 0.014). Conclusion Compared with CCS fixation, FNS fixation, in the treatment of femoral neck fracture in young and middle-aged patients, is superior in that it can significantly reduce times of intraoperative fluoroscopy, shorten operation time and fracture healing time, initiate earlier postoperative full weight-bearing exercises, alleviate patients’ pain and femoral neck shortening, and promote the recovery of hip joint function, thus improving patients’activities of daily living and lowering the risk of postoperative adverse events. |
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