1.Henan University of Chinese Medicine;2.Zhengzhou Orthopedics Hospital
摘要： ［目的］ 分析股骨颈系统固定 Pauwels Ⅲ型股骨颈骨折的短期临床效果。 ［方法］ 回顾性分析2020年3月～2020年8月治疗23例Pauwels Ⅲ型股骨颈骨折患者临床资料。所有患者均行股骨颈系统内固定手术。记录围手术期情况、随访结果及影像学资料。 ［结果］ 手术时间50～110min，平均（66.93±13.12）min。失血量30～88ml，平均（60.30±17.20）ml。切口长度5～8cm，平均（6.50±0.59）cm。随访时间14～20个月，平均（17.22±1.55）个月。22例于3～6个月内临床愈合，平均（4.40±0.95）个月，1例不完全愈合。随着时间变化，患者Harris评分、髋伸-屈ROM及髋内-外旋ROM显著增加（P<0.05）,末次随访时Harris评分81.9～98分，优良率100%。髋关节Garden指数总体呈现减小趋势，但无统计学差异（P>0.05）。股骨颈短缩≥5mm者5例，＞10mm者1例，总短缩率21.7%。23例患者无股骨头坏死、感染、畸形愈合及内固定松动发生。 ［结论］ 股骨颈系统固定Pauwels Ⅲ型股骨颈骨折，能明显降低术后并发症，获得满意临床效果。
Abstract : [Objective] To explore the short-term effectiveness of femoral neck system in treatment of Pauwels type Ⅲ femoral neck fractures. [Methods] A retrospective study was conducted on 23 patients Pauwels type Ⅲ for femoral neck fractures admitted from March 2020 to August 2020.All patients received femoral neck system internal fixation. Perioperative conditions, fracture reduction quality, fracture healing time, femoral neck shortening, postoperative complications, and Harris score were recorded. [Results] The operative time was 50～110 minutes with a mean of (66.93±13.12) minutes. The blood loss was 30～88 ml with a mean of (60.30±17.20) ml. The incision length was 5～8cm, with an average of (6.50±0.59)cm. The follow-up time was 14～20 months with an average of (17.22±1.55) months.22 patients healed in 3～6 months with a mean of (4.40±0.95) months,1 case was incompletely healed. As time changes, Harris score, extension-flexion ROM, and internal-external rotation ROM were significantly increased over time (P<0.05), Harris score at the last follow-up was 81.9～98, excellent and good rate was 100%.The overall Garden index of hip joint showed a decreasing trend, but there was no statistical difference (P>0.05).Femoral neck shortening was ≥5mm in 5 cases and > 10mm in 1 case, with a total shortening rate of 21.7%.No necrosis, infection, malunion or internal fixation loosening occurred in 23 patients. [Conclusion] Femoral neck system fixation of Pauwels type Ⅲ femoral neck fractures can significantly reduce postoperative complications and obtain satisfactory clinical results.