张子宏,郭培义,熊晶晶,林炳基,朱尚媚

目的：比较“F”形空心螺钉与倒三角空心螺钉对治疗青壮年股骨颈骨折的疗效。方法：收集2021年06月至2023年12月之间在我院就诊的42例青壮年股骨颈骨折患者，随机分为“F”形空心螺钉固定组和倒三角空心螺钉固定组，在术后1月和12月时收集患者资料并比较两组术前术后视觉模拟评分法（VAS）评分、髋伸屈ROM评分、Harris评分、Garden对线指数差别及愈合情况。结果：两组患者均获完整随访，两组在手术时间、术口长度、术中出血量及住院时间等方面无明显差异（P＞0.05）。术后1月“F”形空心螺钉组较倒三角空心螺钉组的髋伸屈ROM评分及Harris评分有所改善（P＜0.05），疼痛VAS评分差异无统计学意义（P＞0.05）。术后1年“F”形空心螺钉组随访时患者的VAS评分、髋伸-屈ROM评分及Harris评分均优于传统组倒三角空心螺钉组，差异具有统计学意义（P＜0.05）。此外，“F”形空心螺钉组Garden对线指数和早期愈合率明显高于倒三角空心螺钉组（P＜0.05）。结论：“F”形空心螺钉固定具有稳定的内固定能力，能有效提高青壮年股骨颈骨折患者的愈合率和髋关节功能。

F置钉术；空心螺钉；股骨颈骨折；髋关节功能

[1]Stockton D J,Lefaivre K A,Deakin D E,et al.Incidence,Magnitude,and Predictors of Shortening in Young Femoral Neck Fractures[J].J Orthop Trauma,2015,29(9):e293-e298. [2]Li Z,Zhang X,Li Z,et al.Comparative study of Pauwels type III femoral neck fractures managed by short dynamic hip screw with fibula bone graft or cannulated screws in young adults[J].Ann Transl Med,2020,8(11):681. [3]Li Z,Zhang X,Li Z,et al.Comparative study of Pauwels type III femoral neck fractures managed by short dynamic hip screw with fibula bone graft or cannulated screws in young adults[J].Ann Transl Med,2020,8(11):681.[4]Zhang Y,Liu Y,Zhou G,et al.Fibular Allograft for Osteonecrosis Prevention in the Management of Femoral Neck Fractures:Clinical Outcome and Biomechanical Evaluation[J].Journal of biomaterials and tissue engineering,2015,5(12):937-941. [5]Liu C,Liu M T,Li P,et al.Efficacy evaluation for the treatment of subcapital femoral neck fracture in young adults by capsulotomy reduction and closed reduction[J].Chin Med J(Engl),2015,128(4):483-488. [6]Yang J J,Lin L C,Chao K H,et al.Risk factors for nonunion in patients with intracapsular femoral neck fractures treated with three cannulated screws placed in either a triangle or an inverted triangle configuration[J].J Bone Joint Surg Am,2013,95(1):61-69. [7]程文静,丁国正,谢家兵,等.F 形空心钉与传统 3 枚平行钉治疗 PauwelsⅢ型,股骨颈骨折的疗效比较[J].中国骨 伤,2022,35(7):678-682. [8]Filipov O,Gueorguiev B.Unique stability of femoral neck fractures treated with the novel biplane double-supported screw fixation method:a biomechanical cadaver study[J].Injury,2015,46(2):218-226. [9]王建,冉建,刘修信,等.空心钉“F"技术与倒三角形方式布钉治疗股骨颈骨折的疗效比较[J].中国矫形外科杂 志,2016,24(24):2242-2246. [10]Filipov O B.Biplane Double-supported Screw Fixation of Femoral Neck Fractures:Surgical Technique and Surgical Notes[J].J Am Acad Orthop Surg,2019,27(11):e507-e515. [11]赵兴龙,申建军,冯康虎,等.骨科机器人辅助下 F 钉技术与倒三角平行钉治疗不稳定型股骨颈骨折的疗效比较[J].中国骨 伤,2024,37(2):129-134.

点击下载PDF