【摘要】：目的觀察股骨內(nèi)側(cè)鋼板聯(lián)合空心釘內(nèi)固定治療中青年不穩(wěn)定型股骨頸骨折的臨床療效。方法將22例中青年不穩(wěn)定型股骨頸骨折患者隨機(jī)分為觀察組和對(duì)照組各11例,對(duì)照組采用空心釘內(nèi)固定治療,觀察組采用股骨內(nèi)側(cè)鋼板聯(lián)合空心釘內(nèi)固定治療。采用髖關(guān)節(jié)Harris評(píng)分評(píng)估術(shù)前及術(shù)后第3、6、12個(gè)月髖關(guān)節(jié)功能,參照骨折臨床愈合標(biāo)準(zhǔn)判斷骨折愈合情況,采用VAS評(píng)價(jià)術(shù)前及術(shù)后第3、6、12個(gè)月疼痛情況,統(tǒng)計(jì)術(shù)后股骨頭壞死情況。結(jié)果兩組內(nèi)固定物長(zhǎng)度適中,位置滿意,未累及關(guān)節(jié)面或進(jìn)入關(guān)節(jié)腔;均無(wú)重要血管損傷,未發(fā)現(xiàn)髖關(guān)節(jié)活動(dòng)限制;切口均達(dá)甲級(jí)愈合,未發(fā)現(xiàn)切口感染。觀察組9例骨性愈合并負(fù)重行走,1例骨折線明顯模糊;均未見(jiàn)股骨頭壞死征象,髖關(guān)節(jié)活動(dòng)良好無(wú)限制。對(duì)照組6例骨性愈合并負(fù)重行走,4例骨折線明顯模糊;1例術(shù)后第7個(gè)月出現(xiàn)股骨頭壞死,空心釘切出并退釘,后行全髖關(guān)節(jié)置換術(shù)。兩組術(shù)后各時(shí)點(diǎn)與術(shù)前比較,Harris評(píng)分均升高、VAS均降低(P均0.01);與對(duì)照組比較,觀察組術(shù)后各時(shí)點(diǎn)Harris評(píng)分均升高(P均0.05),術(shù)后第6、12個(gè)月VAS均降低(P均0.05)。結(jié)論采用股骨內(nèi)側(cè)鋼板聯(lián)合空心釘內(nèi)固定治療中青年不穩(wěn)定型股骨頸骨折,可有效復(fù)位骨折并穩(wěn)定內(nèi)固定,改善髖關(guān)節(jié)功能并減輕疼痛。
[Abstract]:Objective to observe the clinical effect of medial femoral plate combined with hollow nail fixation in the treatment of unstable femoral neck fracture in middle and young people. Methods 22 young and middle-aged patients with unstable femoral neck fracture were randomly divided into observation group (n = 11) and control group (n = 11). The control group was treated with hollow nail internal fixation, and the observation group was treated with medial femoral plate combined with hollow nail internal fixation. Hip joint function was evaluated by Harris before operation and 3,6,12 months after operation. Fracture healing was evaluated according to clinical criteria of fracture healing. Pain was evaluated by VAS before operation and 3,6,12 months after operation. The necrosis of femoral head after operation was counted. Results the length of internal fixator in both groups was moderate, the position was satisfactory, the articular surface was not involved or entered into the joint cavity, there was no important vascular injury, no restriction of hip joint activity was found, the incision healed in grade A and no incision infection was found. In the observation group, there were 9 cases of bone healing and weight-bearing walking, 1 case of fracture line obviously blurred, no sign of osteonecrosis of femoral head and good activity of hip joint. In the control group, bone healing and weight-bearing walking were found in 6 cases, fracture line was obviously blurred in 4 cases, osteonecrosis of femoral head appeared in 1 case 7 months after operation, hollow nail was cut out and removed, then total hip arthroplasty was performed. Compared with pre-operation, Harris scores increased and VAS decreased in both groups at each time point after operation (P0.01). Compared with the control group, the Harris scores in the observation group increased at all time points after operation (all P0.05), and the VAS decreased at the 6th and 12th months after the operation (all P0.05). Conclusion the treatment of unstable femoral neck fracture with medial femoral plate combined with hollow nail fixation can effectively reduce fracture and stabilize internal fixation, improve hip joint function and relieve pain.
【作者單位】： 山東中醫(yī)藥大學(xué);山東中醫(yī)藥大學(xué)附屬醫(yī)院;
【分類號(hào)】：R687.3

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