经皮加压钢板与空心钉治疗股骨颈骨折的临床疗效比较

Clinical curative effect of percutaneous compression plating and cannulated screw for treatment of femoral neck fractures

摘要:

目的比较经皮加压钢板和空心螺钉治疗股骨颈骨折的临床疗效。方法选取2012～2015 年来该院采用经皮加压钢板（PCCP）治疗股骨颈骨折病例32 例，与同期采用空心螺钉固定的股骨颈骨折32 例进行随访比较。PCCP 组，男性14 例，女性18 例；平均年龄42.5 岁（27～59 岁）；车祸伤20 例，跌伤10 例，高处坠落伤2 例；均为闭合性骨折，无明显合并症；Garden分型，Ⅰ型3 例，Ⅱ型5例，Ⅲ18 例，Ⅳ型6 例。空心钉组，男性20 例，女性12 例；平均年龄43.3 岁（23～61 岁）；车祸伤22 例，跌伤10 例；均为闭合性骨折，无明显合并症；Garden分型，Ⅰ型4 例，Ⅱ型9 例，Ⅲ17 例，Ⅳ型2 例。对两组患者的手术时间、住院时间、骨折愈合时间、Harris髋关节功能评分进行比较，并进行统计学分析。结果两组患者住院时间、骨折愈合时间、Harris 髋关节功能评分比较，差异无统计学意义（p >0.05）,但PCCP 组并发症更少，差异有统计学意义（p <0.05）。结论PCCP可使骨折端加压，但又控制过度压缩，钉板结合可防止颈干角丢失，两枚螺钉固定具有抗旋转能力，是治疗股骨颈骨折的一种疗效确切的方法。

Abstract:

Objective To compare the clinical effect of percutaneous compression plate (PCCP) and cannulated screw for treatment of femoral neck fractures. Methods From 2012 to 2015, 32 cases of femoral neck fracture were treated with PCCP (PCCP group) and 32 cases were treated with cannulated screw (cannulated screw group) in our hospital. In the PCCP group, there were 14 males and 18 females with the average age of 42.5 y; the patients had closed fractures due to traffic accidents (20 cases), tumble (10 cases), or falling from height (2 cases) without obvious complications; for Garden typing, there were 3 cases of type Ⅰ, 5 cases of type Ⅱ, 18 cases of type Ⅲ and 6 cases of type Ⅳ. In the cannulated screw group, there were 20 males and 12 females with the average age of 43.3 y; the patients had closed fractures due to traffic accident (22 cases) or tumble (10 cases), there were no obvious complications; for Garden typing, there were 4 cases of type I, 9 cases of type Ⅱ, 17 cases of type Ⅲand 2 cases of type Ⅳ. The operation time, duration of hospital stay, fracture healing time and Harris hip function score were compared between the two groups, and statistical analyses were performed. Results The hospital time, fracture healing time and Harris hip function score had no statistical differences between the two groups (p > 0.05); but the PCCP group had fewer complications than the cannulated screw group (p < 0.05). Conclusions PCCP can pressurize the fracture ends, but avoid excessive compression. Nail and plate combination can prevent the loss of neck stem angle. Two -screw fixation can resist rotation. Therefore, PCCP is an effective curative method for the treatment of femoral neck fracture.