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经皮加压钢板与空心加压螺钉治疗中青年移位型股骨颈骨折的疗效比较

[Comparison of curative effect between percutaneous compression plate and cannulated compression screw in the treatment of displaced femoral neck fractures in young and middle-aged patients].

作者信息

Cui Xue-Liang, Li He, Shi Liu, Xie Wen-Jun, Chen Hui

机构信息

Department of Orthopaedics, Zhongda Hospital Southeast University, Nanjing 210009, Jiangsu, China; Trauma Center, Zhongda Hospital Southeast University, Nanjing 210009, Jiangsu, China; Orthopaedic Trauma Institute of Southeast University, Nanjing 210009, Jiangsu, China.

出版信息

Zhongguo Gu Shang. 2023 Mar 25;36(3):226-31. doi: 10.12200/j.issn.1003-0034.2023.03.006.

Abstract

OBJECTIVE

To compare the efficacy of percutaneous compression plate and cannulated compression screw in the treatment of displaced femoral neck fractures in young and middle-aged patients.

METHODS

From January 2015 to July 2020, 68 young and middle-aged patients with displaced femoral neck fracture were retrospectively analyzed. Among them, 31 cases were fixed by percutaneous compression plate (PCCP), and 37 cases were fixed by cannulated compression screw (CCS). General data such as gender, age, cause of injury, comorbidities, fracture classification and cause of injury of two groups were collected. The operation time, intraoperative blood loss, hospital stay, full weight bearing time, fracture healing time, visual analogue scale(VAS), Harris hip score and complications were compared between two groups.

RESULTS

Patients in both groups were followed up for more than 2 years. There were no significant differences in operation time, intraoperative blood loss, fracture reduction quality, hospital stay and VAS between two groups. The fracture healing time in PCCP group was significantly shorter than that in CCS group (=-4.404, =0.000). The complete weight bearing time of PCCP group was significantly shorter than that of CCS group (=-9.011, =0.000). Harris score of hip joint in PCCP group was better than that in CCS group 2 years after operation (=0.002). Complications occurred in 3 cases (9.68%) in PCCP group, while 11 cases (29.72%) in CCS group, with a statistically significant difference (=0.042).

CONCLUSION

Both PCCP and CCS can be used for the treatment of displaced femoral neck fractures in young and middle-aged people. Compared with CCS, PCCP fixation can achieve shorter fracture healing time and create conditions for early full weight bearing. PCCP results in higher hip score and lower complications.

摘要

目的

比较经皮加压钢板与空心加压螺钉治疗中青年移位型股骨颈骨折的疗效。

方法

回顾性分析2015年1月至2020年7月68例中青年移位型股骨颈骨折患者。其中,31例采用经皮加压钢板(PCCP)固定,37例采用空心加压螺钉(CCS)固定。收集两组患者的性别、年龄、受伤原因、合并症、骨折分类及受伤原因等一般资料。比较两组患者的手术时间、术中出血量、住院时间、完全负重时间、骨折愈合时间、视觉模拟评分(VAS)、Harris髋关节评分及并发症情况。

结果

两组患者均随访2年以上。两组患者的手术时间、术中出血量、骨折复位质量、住院时间及VAS评分比较,差异均无统计学意义。PCCP组骨折愈合时间明显短于CCS组(=-4.404,=0.000)。PCCP组完全负重时间明显短于CCS组(=-9.011,=0.000)。术后2年PCCP组髋关节Harris评分优于CCS组(=0.002)。PCCP组发生并发症3例(9.68%),CCS组发生11例(29.72%),差异有统计学意义(=0.042)。

结论

PCCP和CCS均可用于中青年移位型股骨颈骨折的治疗。与CCS相比,PCCP固定可缩短骨折愈合时间,为早期完全负重创造条件。PCCP可获得更高的髋关节评分,并发症更少。

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