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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
100853, 北京市复兴路28号
电话:010-66936756
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E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
段宏波,任辉,吴昊.强斜低位空心钉联合缝匠肌骨瓣治疗老年GardenⅢ型和Ⅳ型股骨颈骨折疗效[J].中华老年多器官疾病杂志,2019,18(4):256~260
强斜低位空心钉联合缝匠肌骨瓣治疗老年GardenⅢ型和Ⅳ型股骨颈骨折疗效
Therapeutic effect of strong oblique low cannulated screw fixation combined with sartorius musculoskeletal flap for Garden Ⅲ and Ⅳ femoral neck fracture in the elderly
投稿时间:2018-11-29  
DOI:10.11915/j.issn.1671-5403.2019.04.052
中文关键词:  老年人;股骨颈骨折;缝匠肌;骨瓣
英文关键词:aged; femoral neck fractures; sartorius muscle; bone flap
基金项目:秦皇岛市科学技术局重点研发计划项目(201703A139)
作者单位E-mail
段宏波 秦皇岛市工人医院骨一科,秦皇岛 066200 365458591@qq.com 
任辉 秦皇岛市工人医院急诊科,秦皇岛 066200  
吴昊 秦皇岛市工人医院骨一科,秦皇岛 066200  
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中文摘要:
      目的 探究强斜低位空心钉联合缝匠肌骨瓣治疗老年GardenⅢ、Ⅳ型股骨颈骨折疗效。方法 入选秦皇岛市工人医院骨科2016年6月至2017年8月老年GardenⅢ、Ⅳ型股骨颈骨折患者86例,随机数字表法分为对照组和研究组,每组43例。对照组使用常规平行加压空心钉内固定术治疗,研究组使用强斜低拉空心钉联合缝匠肌骨瓣进行治疗,比较2组患者术中指标、视觉模拟量表(VAS)评分、Harris髋关节功能评分和不良事件发生率。采用SPSS 21.0统计软件对数据进行分析。组间比较采用t检验或χ2检验。结果 对照组相比研究组手术时间[(72.56±10.48) vs(84.17±12.33)min]和术中出血量[(125.48±11.52) vs(164.72±14.89)ml]减少,差异具有统计学意义(P<0.05)。研究组VAS评分相比对照组术后5 d[(4.82±1.02) vs(5.69±1.07)分]和10 d[(3.28±0.85) vs(4.34±0.94)分]降低,差异具有统计学意义(P<0.05)。研究组Harris评分相比对照组术后1个月[(58.79±4.28) vs(51.25±3.63)分]、3个月[(78.46±6.47) vs(70.54±5.89)分]和6个月[(84.07±6.98) vs(79.22±6.51)分]显著高,差异具有统计学意义(P<0.05)。对照组相比研究组不良事件发生率高[48.83%(21/43) vs 20.93%(9/43)],差异具有统计学意义(χ2=7.371,P=0.007)。结论 强斜低位空心钉联合缝匠肌骨瓣治疗能有效降低老年GardenⅢ、Ⅳ型股骨颈骨折患者术后疼痛,改善术后关节功能,减少不良事件发生。
英文摘要:
      Objective To investigate the clinical efficacy of strong oblique low position cannulated screw combined with sartorius muscle bone flap in the treatment of senile Garden Ⅲ and Ⅳ femoral neck fracture. Methods A total of 86 elderly patients with Garden Ⅲ and Ⅳ femoral neck fractures admitted in our department from June 2016 to August 2017 were recruited and randomly divided into control group (n=43) and study group (n=43). The patients of the control group were treated with conventional parallel compression cannulated screw internal fixation, and those of the study group were treated with strong oblique low tension cannulated screw combined with sartorius muscle bone flap. The intraoperative indices, visual analogue scale (VAS) score, Harris hip function score and incidence of adverse events were compared between the 2 groups. SPSS statistics 22.0 was used for data analysis. Student′s t test or Chi-square test was employed for comparison between groups. Results The control group had significantly shorter operation time [(72.56±10.48) vs (84.17±12.33)min] and less intraoperative bleeding [(125.48±11.52) vs (164.72±14.89)ml] than the study group (P<0.05). The VAS score was significantly lower in the study group than the control group on the 5th day [(4.82±1.02) vs (5.69±1.07)] and 10th day [(3.28±0.85) vs (4.34±0.94)] after operation (P<0.05). The Harris score was obviously higher in the study group than the control group in 1 month [(58.79±4.28) vs (51.25±3.63)], 3 months [(78.46±6.47) vs (70.54±5.89)] and 6 months after surgery [(84.07±6.98) vs (79.22±6.51), P<0.05]. The incidence of adverse events was notably higher in the control group than the study group [48.83%(21/43) vs 20.93%(9/43), χ2=7.371, P=0.007]. [JP+1]Conclusion Strong oblique low position cannulated screw fixation combined with sartorius muscle bone flap can effectively reducepostoperative pain, improve joint function and reduce the incidence of adverse events in the elderly patients with Garden Ⅲ and Ⅳ femoral neck fractures.
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