摘要
目的:观察中青年股骨颈骨折患者行改良髋关节前外侧(S-P)入路切开复位同种异体腓骨植入术的中远期临床疗效。方法:选择2016年3月-2017年12月中青年股骨颈骨折切开复位内固定手术治疗患者38例,根据术中是否植骨分为植骨组和非植骨组。植骨组18例,行改良S-P入路切开复位双头加压空心钉+同种异体腓骨棒植入术;非植骨组20例,行切开复位普通空心拉力钉内固定术。比较两组临床疗效。结果:两组手术时间、术中出血量和术口长度比较,差异均无统计学意义(P>0.05)。所有病例术后随访(46.32±5.28)个月。植骨组骨性愈合16例,出现股骨头坏死2例;非植骨组骨性愈合12例,股骨头坏死8例。植骨组骨折愈合率、末次随访髋关节功能哈里斯(Harris)评分均优于非植骨组,股骨头坏死率低于非植骨组,差异有统计学意义(P<0.05)。植骨组无内固定并发症发生,非植骨组5例内固定松动,两组比较差异有统计学意义(P<0.05)。结论:改良S-P入路切开复位同种异体腓骨植入术治疗中青年股骨颈骨折,可明显提升骨折愈合率,显著降低股骨头坏死率。
Objective:To observe the middle and long-term clinical effect of modified Smith-Petersen(S-P)approach for open reduction and allograft fibula implantation in young and middle-aged patients with femoral neck fracture.Methods:A retrospective study was performed on 38 young and middle-aged patients who received open reduction and internal fixation(ORIF)for femoral neck fractures from March 2016 to December 2017.In term of whether or not bone graft used,they were divided into two groups,including the grafted group in which 18 patients were treated with modified S-P approach open reduction and double head compression cannulated screw combined with allogeneic fibula implantation,and the non-grafted group in which 20 patients received open reduction and internal fixation with the screws only.The clinical data were compared between the two groups.Results:There were no statistically differences of the operative time,blood loss and incision length between two groups(P>0.05).All patients were followed up(46.32±5.28)months.In the grafted group,16 got fracture healing,2 had femoral head necrosis.By contrast,12 were of bony healing,8 of femoral head necrosis in the non-grafted group.The grafted group took statistically higher fracture healing rate and higher excellent and good rate based on Harris scores,whereas statistically lower femoral head necrosis rate than the non-grafted group(P<0.05).No internal fixation loosening or breaking happened in any patient of the grafted group,while 5 patients in the non-grafted group had implant loosening and displacement,there was significient difference.Conclusion:The modified S-P approach open reduction and allogeneic fibula implantation in the treatment of young and middle-aged femoral neck fractures can effectively improve the fracture healing rate and reduce the rate of femoral head necrosis,which is more reliable than the application of hollow lag screws alone.
作者
杜兰翔
李世梁
肖嵘
李世佳
王志相
刘盛飞
DU Lanxiang;LI Shiliang;XIAO Ro ng;LI Shijia;WANG Zhixiang;LIU Shengfei(Ganzhou Hospital of Traditional Chinese Medicine,Ganzhou 341000,China)
出处
《临床医药实践》
2022年第1期13-17,共5页
Proceeding of Clinical Medicine
基金
江西省卫生健康委员会科技计划项目(项目编号:20204637)。
关键词
股骨颈骨折
同种异体腓骨
双头加压钉
femoral neck fractures
fibular allograft
double head cannulated compression screw
作者简介
杜兰翔(1974-),男,江西省赣州市人,学士学位,副主任医师。研究方向:创伤骨科。E-mail:18370488287@139.com;通信作者:李世梁。
