股骨颈骨折患者使用加压支撑螺钉的临床价值和风险因素

IF 2.8 3区医学 Q1 ORTHOPEDICS

Journal of Orthopaedic Surgery and Research Pub Date : 2024-09-19 DOI:10.1186/s13018-024-04873-y

Yazhou Zhang, Guanqing Li, Zhi Tian, Can Cao, Changmao Qiu, Xicheng Li

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引用次数: 0

摘要

本研究旨在探讨加压支撑螺钉治疗股骨颈骨折的临床价值和风险因素。这项回顾性分析选取了我院 2020 年 6 月至 2022 年 6 月期间收治的 102 例股骨颈骨折患者。根据手术中使用的螺钉不同，参与者被分为空心螺钉组（52例，平行部分螺纹空心螺钉常规固定）和加压螺钉组（50例，加压螺钉固定）。加压螺钉组的并发症（包括内固定失败、不愈合、股骨头血管坏死、股骨颈缩短小于10毫米、患肢侧向螺钉脱出）发生率明显低于空心螺钉组（P < 0.05）。本研究对患者进行了 9 至 14 个月的随访，平均随访时间为（12.09 ± 1.87）个月，加压螺钉组术后 3 天、10 天和最后一次随访时的疼痛程度明显低于空心螺钉组（P < 0.05）。在最后一次随访中，加压螺钉组的髋关节功能改善比空心螺钉组更明显（P < 0.05）。单变量逻辑回归分析显示，使用加压支撑螺钉治疗股骨颈骨折并发症的危险因素为年龄、Pauwels III 型骨折（改良 Pauwels 分类）和髋关节（≥ 90 分）。此外，多变量逻辑回归分析结果显示，使用加压支撑螺钉治疗股骨颈骨折并发症的风险因素为年龄、Pauwels III 型骨折（改良 Pauwels 分类）。我们的研究结果表明，使用加压支撑螺钉能有效促进股骨颈骨折患者的康复，并减少相关并发症的发生。

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Clinical value and risk factors of compression supporting screwsin patients with femoral neck fractures

This study was performed with attempt to explore the clinical value and risk factors of compression supporting screws for the treatment of femoral neck fractures. This retrospective analysis enrolled 102 patients with femoral neck fractures who admitted to our hospital from June 2020 to June 2022. Based on different screws during the operation, the participants were allocated into hollow screw group (52 cases, conventional fixation of parallel partial-thread hollow screw) and compression screw group (50 cases, compression screw fixation). The incidence of complications (including internal fixation failure, nonunion, a vascular necrosis of the femoral head, shortening of the femoral neck by less than 10 mm, and lateral screw withdrawal, of the affected limb) in the compression screw group were significantly lower than those in the hollow screw group (P < 0.05). Patients enrolled in this study were followed up for 9 to 14 months, with an average follow-up time of (12.09 ± 1.87) months.The pain degree at 3 days, 10 days, and the last follow-up after operation in the compression screw group was evidently lower than that in the hollow screw group (P < 0.05). At the last follow-up, the improvment in hip joint function was more significant in the compression screw group than in the hollow screw group (P < 0.05). Univariate logistic regression analysis showed that the risk factors for complications in the treatment of femoral neck fractures with compression supporting screws were age, Pauwels type III fracture (modified Pauwels classification), and hip joint (≥ 90 points). In addition, the result of multivariate logistic regression analysis showed that the risk factors for complications in the treatment of femoral neck fractures with compression supporting screws were age, Pauwels type III fracture (modified Pauwels classification). Our findings demonstrated beneficial outcomes obtained by using compression supporting screw, in terms of effectively enhancing the recovery of patients with femoral neck fracture and reducing the associated complications.

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来源期刊

Journal of Orthopaedic Surgery and Research ORTHOPEDICS-

CiteScore

4.10

自引率

7.70%

发文量

494

审稿时长

>12 weeks

期刊介绍： Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.