CAJ | 학술논문

目的：比较两种空心钉不同排列方式对老年股骨颈骨折术后疗效的影响。方法2010年2月至2012年1月我科治疗老年股骨颈骨折142例，其中行空心加压螺钉固定87例，分别使用两种不同排列方式的空心钉，A 组行经矩立体交叉排列方式，共45例，男17例，女28例，平均年龄（73.66±8.01）岁；B 组行 AO 三角形排列方式，共42例，其中男13例，女29例；平均年龄（75.16±8.52）岁。分别记录并比较两组患者术中出血量、手术时间、C 型臂照射时间、住院时间；此外，术后1年对两组患者患侧髋关节活动功能及股骨颈短缩情况进行随访并比较。结果两组比较，年龄、性别、合并症、美国麻醉医师协会（American society of anesthesiologists，ASA）评分、骨折类型、骨密度差异无统计学意义（P >0.05）；对术中情况进行比较，发现两组患者麻醉方式、出血量、手术时间及 C 型臂透视时间均差异无统计学意义（P >0.05）；术后1年随访，A 组（经矩立体交叉排列方式）中，3例随访期间死亡，39例骨折愈合，2例骨折不愈合，3例失效，1例股骨头缺血坏死，其中14例发生股骨颈短缩，Harris 髋关节功能评分平均（85.13±10.30）分；B组（三角形排列方式）中，2例死亡，39例骨折愈合，1例骨折不愈合，1例失效，没有股骨头缺血坏死的病例，23例发生股骨颈短缩，Harris 髋关节功能评分平均（78.44±14.17）分。两组相比，B 组（三角形排列方式）较 A 组（经矩立体交叉排列方式）更容易发生股骨颈短缩（P <0.01），同时 Harris 评分较 A 组小，说明患肢功能较差（P <0.01）。结论三角形排列方式治疗老年股骨颈骨折较经矩立体交叉排列方式更容易发生股骨颈短缩，髋关节功能也较差。
목적：비교량충공심정불동배렬방식대노년고골경골절술후료효적영향。방법2010년2월지2012년1월아과치료노년고골경골절142례，기중행공심가압라정고정87례，분별사용량충불동배렬방식적공심정，A 조행경구입체교차배렬방식，공45례，남17례，녀28례，평균년령（73.66±8.01）세；B 조행 AO 삼각형배렬방식，공42례，기중남13례，녀29례；평균년령（75.16±8.52）세。분별기록병비교량조환자술중출혈량、수술시간、C 형비조사시간、주원시간；차외，술후1년대량조환자환측관관절활동공능급고골경단축정황진행수방병비교。결과량조비교，년령、성별、합병증、미국마취의사협회（American society of anesthesiologists，ASA）평분、골절류형、골밀도차이무통계학의의（P >0.05）；대술중정황진행비교，발현량조환자마취방식、출혈량、수술시간급 C 형비투시시간균차이무통계학의의（P >0.05）；술후1년수방，A 조（경구입체교차배렬방식）중，3례수방기간사망，39례골절유합，2례골절불유합，3례실효，1례고골두결혈배사，기중14례발생고골경단축，Harris 관관절공능평분평균（85.13±10.30）분；B조（삼각형배렬방식）중，2례사망，39례골절유합，1례골절불유합，1례실효，몰유고골두결혈배사적병례，23례발생고골경단축，Harris 관관절공능평분평균（78.44±14.17）분。량조상비，B 조（삼각형배렬방식）교 A 조（경구입체교차배렬방식）경용역발생고골경단축（P <0.01），동시 Harris 평분교 A 조소，설명환지공능교차（P <0.01）。결론삼각형배렬방식치료노년고골경골절교경구입체교차배렬방식경용역발생고골경단축，관관절공능야교차。
Objective To investigate the treatment effect of hip after fixation of femoral neck fractures using cannulated screws. Methods A prospective study of 87 elderly femoral neck fracture cases was February 2010 to January 2012. There were 87 elderly femoral neck fracture patients admitted and satisfied standards. The patients were divided into two groups. In A group of 45 patients,three cannulated screws were placed with across solid flame,and three cannulated screws were placed with triangle arrangement in B group of 42 patients. Survey and compare the medical records of patients with sex,age,ASA score, fracture type,comorbidities between two groups. Through the operation records and postoperative follow-up,we compared two groups of the operative time,bleed volume,X-ray exposure time,surgical methods,anesthesia,femoral neck shorting,and post operative recovery of hip function. Results By comparing the two groups in sex,age,ASA score,fracture type,comorbidities, operative time ,bleed volume ,X - ray exposure time ,surgical methods ,and anesthesia ,there was no significant difference( P >0. 05). But comparing femoral neck shorting and Harris scores,there was significant difference(P < 0. 05). The Harris score of triangle arrangement group were less than A group. There weere more femoral neck shorting in group A. Conclusion Using three cannulated screws placed with across solid flame treated the elderly femoral neck fracture is more effective than triangle arrangement group methods in Harris and femoral neck shorting.