髋关节镜辅助复位联合内固定治疗青壮年移位型股骨颈骨折的临床疗效
|
摘要
目的探讨髋关节镜辅助复位联合内固定治疗青壮年移位型股骨颈骨折的临床疗效。方法回顾性分析我院2016年1月-2018年10月收治的青壮年移位型股骨颈骨折患者69例,根据治疗方法不同分为对照组与观察组,其中对照组35例,观察组34例。对照组患者接受常规手术治疗,观察组患者接受髋关节镜辅助复位联合内固定治疗。比较两组患者隐性及显性失血量、疼痛情况、髋关节功能。结果观察组患者术中及术后隐性及显性失血量少于对照组(P<0.05)。两组患者术前VAS评分比较差异无统计学意义(P>0.05)。术后6h、12h、24h观察组患者VAS评分低于对照组(P<0.05)。观察组患者髋关节功能评分高于对照组(P<0.05),负重时间少于对照组(P<0.05)。结论髋关节镜辅助复位联合内固定是治疗青壮年移位型股骨颈骨折有效方法,该方案可降低患者术后疼痛,改善髋关节功能,减少术中出血量,应大力推荐使用。
Objective To investigate the clinical efficacy of hip arthroscopic assisted reduction combined with internal fixation for the treatment of displaced femoral neck fracture in young adults.Methods 69 cases of displaced femoral neck fracture young adults treated in our hospital from January 2016 to October 2018 were selected and divided into two groups according to the different treatment,namely,control group(n=35) and observation group(n=35).The control group received the routine surgery,while the observation group received the hip arthroscopic assisted reduction combined with internal fixation.Then the recessive and dominant blood loss,pain degrees,and hip function were compared between the two groups.Results The amount of latent and dominant blood loss in the observation group was significantly lower than that in the control group(P<0.05).The preoperative VAS scores between the two groups had no difference(P>0.05),which were lower in the observation group than those of the control group at postoperative 6 h,12 h and 24 h(P<0.05).The hip function score of the observation group was significantly higher than that of the control group(P<0.05),and the weight-bearing time was less than that of the control group(P<0.05).Conclusion The application of the hip arthroscopic assisted reduction combined with internal fixation can effectively relieve postoperative pain,improve hip function,and reduce intraoperative blood loss for displaced femoral neck fracture in young adults,which is recommended.
Objective To investigate the clinical efficacy of hip arthroscopic assisted reduction combined with internal fixation for the treatment of displaced femoral neck fracture in young adults.Methods 69 cases of displaced femoral neck fracture young adults treated in our hospital from January 2016 to October 2018 were selected and divided into two groups according to the different treatment,namely,control group(n=35) and observation group(n=35).The control group received the routine surgery,while the observation group received the hip arthroscopic assisted reduction combined with internal fixation.Then the recessive and dominant blood loss,pain degrees,and hip function were compared between the two groups.Results The amount of latent and dominant blood loss in the observation group was significantly lower than that in the control group(P<0.05).The preoperative VAS scores between the two groups had no difference(P>0.05),which were lower in the observation group than those of the control group at postoperative 6 h,12 h and 24 h(P<0.05).The hip function score of the observation group was significantly higher than that of the control group(P<0.05),and the weight-bearing time was less than that of the control group(P<0.05).Conclusion The application of the hip arthroscopic assisted reduction combined with internal fixation can effectively relieve postoperative pain,improve hip function,and reduce intraoperative blood loss for displaced femoral neck fracture in young adults,which is recommended.
引文
[1] 张施展,张卫国,汪阳,等.髋关节镜辅助下复位联合空心钉内固定治疗青壮年移位型股骨颈骨折[J].骨科,2018(4).
[2] 李谋林,周智,尹文军,等.切开复位内固定联合旋髂深血管束髂骨瓣移植治疗青壮年股骨颈骨折[J].中国现代手术学杂志,2017,21(5):361-365.
[3] 李文龙,梅沉成,张蕾蕾,等.切开复位联合内固定治疗青壮年PauwelsⅡ,Ⅲ型股骨颈骨折43例[J].中国中医骨伤科杂志,2016(10):54-57.
[4] 李梁,梁学振,滕加文.股骨内侧钢板联合空心钉内固定治疗中青年不稳定型股骨颈骨折效果观察[J].山东医药,2017,57(34):80-82.
[5] 杨明轩,罗志强,刘昊楠,等.内固定与全髋关节置换治疗移位型股骨颈骨折的中期疗效[J].实用医学杂志,2017,33(10):1651-1655.
[7] 薛文,管晓鹂,王增平,等.闭合复位股骨近端空心钉锁定板固定治疗青壮年移位股骨颈骨折[J].中国骨伤,2016,29(7):645-647.
[8] Hoshino C M,Christian M W,O’Toole R V,et al.Fixation of displaced femoral neck fractures in young adults:Fixed-angle devices or Pauwel screws?[J].Injury-international Journal of the Care of the Injured,2016,47(8):1676-1684.
[9] Jam G,Rocha L R,Noronha Rocha T H,et al.Vertical femoral neck fractures in young adults:a closed fixation strategy using a transverse cancellous lag screw[J].Injury-international Journal of the Care of the Injured,2017,48 Suppl 4:S10.
[10] 李漌涼,李章华.全髋关节置换术与骨折内固定术治疗老年移位型股骨颈骨折的临床效果[J].中国医药导报,2016,13(36):112-116.
[11] 王松华,刘璠,查涛,等.经皮加压钢板固定治疗中青年移位型股骨颈骨折[J].中华创伤骨科杂志,2016,18(11):932-937.
[12] 蔡延禄,吴漾,林冬杰.闭合复位空心加压螺钉治疗股骨颈骨折的疗效分析[J].广东医学,2016,37(15):2302-2303.
[13] 黄屾.髋关节置换术与骨折内固定术治疗新鲜移位的老年股骨颈骨折的疗效对比[J].创伤外科杂志,2016,18(4):223-225.
[14] 西尔买买提;艾哈提,艾克热木江;阿尔肯,丁舒晨,等.动力髋螺钉联合防旋钉内固定治疗股骨颈骨折术后股骨头坏死的影响因素分析[J].中华创伤杂志,2017,33(9):158-162.
[15] 张立志,高杰,张志成,等.人工髋关节置换和空心钉内固定治疗高龄患者股骨颈骨折的临床疗效对比[J].中国骨伤,2018,31(2):103-110.
[2] 李谋林,周智,尹文军,等.切开复位内固定联合旋髂深血管束髂骨瓣移植治疗青壮年股骨颈骨折[J].中国现代手术学杂志,2017,21(5):361-365.
[3] 李文龙,梅沉成,张蕾蕾,等.切开复位联合内固定治疗青壮年PauwelsⅡ,Ⅲ型股骨颈骨折43例[J].中国中医骨伤科杂志,2016(10):54-57.
[4] 李梁,梁学振,滕加文.股骨内侧钢板联合空心钉内固定治疗中青年不稳定型股骨颈骨折效果观察[J].山东医药,2017,57(34):80-82.
[5] 杨明轩,罗志强,刘昊楠,等.内固定与全髋关节置换治疗移位型股骨颈骨折的中期疗效[J].实用医学杂志,2017,33(10):1651-1655.
[7] 薛文,管晓鹂,王增平,等.闭合复位股骨近端空心钉锁定板固定治疗青壮年移位股骨颈骨折[J].中国骨伤,2016,29(7):645-647.
[8] Hoshino C M,Christian M W,O’Toole R V,et al.Fixation of displaced femoral neck fractures in young adults:Fixed-angle devices or Pauwel screws?[J].Injury-international Journal of the Care of the Injured,2016,47(8):1676-1684.
[9] Jam G,Rocha L R,Noronha Rocha T H,et al.Vertical femoral neck fractures in young adults:a closed fixation strategy using a transverse cancellous lag screw[J].Injury-international Journal of the Care of the Injured,2017,48 Suppl 4:S10.
[10] 李漌涼,李章华.全髋关节置换术与骨折内固定术治疗老年移位型股骨颈骨折的临床效果[J].中国医药导报,2016,13(36):112-116.
[11] 王松华,刘璠,查涛,等.经皮加压钢板固定治疗中青年移位型股骨颈骨折[J].中华创伤骨科杂志,2016,18(11):932-937.
[12] 蔡延禄,吴漾,林冬杰.闭合复位空心加压螺钉治疗股骨颈骨折的疗效分析[J].广东医学,2016,37(15):2302-2303.
[13] 黄屾.髋关节置换术与骨折内固定术治疗新鲜移位的老年股骨颈骨折的疗效对比[J].创伤外科杂志,2016,18(4):223-225.
[14] 西尔买买提;艾哈提,艾克热木江;阿尔肯,丁舒晨,等.动力髋螺钉联合防旋钉内固定治疗股骨颈骨折术后股骨头坏死的影响因素分析[J].中华创伤杂志,2017,33(9):158-162.
[15] 张立志,高杰,张志成,等.人工髋关节置换和空心钉内固定治疗高龄患者股骨颈骨折的临床疗效对比[J].中国骨伤,2018,31(2):103-110.