新型牵引床闭合复位空心钉固定股骨颈骨折

A novel traction table for closed reduction and cannulated screw fixation of femoral neck fractures

摘要:

［目的］ 探讨一种新型牵引床在闭合复位空心钉固定治疗股骨颈骨折中的临床效果。［方法］ 2019 年 2 月—2020 年 8 月，58 名股骨颈骨折患者纳入本研究，依据术前医患沟通结果，28 例术中使用新型牵引床（新型组），30 例术中使用传统牵引床 （传统组）。比较两组临床及影像结果。［结果］ 新型组体位摆放时间显著短于传统组 （P<0.05），但两组闭合复位时间、 手术时间、术中出血量、透视次数的差异均无统计学意义（P>0.05）。两组完全负重时间的差异无统计学意义（P>0.05）。与术后 3 个月比较，末次随访时，两组伸-屈 ROM、Harris 评分均显著改善（P<0.05），相应时间点，两组伸-屈 ROM、Harris 评分的差异均无统计学意义（P>0.05）。影像方面，末次随访时两组 Garden 指数、头颈短缩、颈干角均有不良改变，其中，Garden 指数的变化无统计学意义（P>0.05），而头颈短缩和颈干角有统计学意义（P<0.05）。相应时间点两组间 Garden 指数、头颈短缩和颈干角的差异均无统计学意义 （P>0.05），两组间骨折愈合时间的差异无统计学意义 （P>0.05）。［结论］ 新型牵引床能够有效减少体位摆放时间、提高手术效率。

Abstract:

[Objective] To investigate the clinical efficiency of a novel traction table for closed reduction and cannulated screw fixation of femoral neck fractures. [Methods] From February 2019 to August 2020, 58 patients with femoral neck fracture were enrolled in this study. According to preoperative doctor-patient communication, 28 patients were treated with new traction table (the novel group) , while the remaining 30 patients were treated with traditional traction table (the traditional group) . The clinical and imaging results of the two groups were compared. [Results] The novel group proved significantly superior to the traditional group in term of body positioning time (P< 0.05) , but there were no significant differences in closed reduction time, operation time, intraoperative blood loss and fluoroscopic times be- tween the two groups (P>0.05) . In addition, there was no significant difference in the time to return fully weight-bearing between the two groups (P>0.05) . Compared with those 3 months after surgery, extension-flexion ROM and Harris score significantly improved in both groups at the latest follow-up (P<0.05) , but which was not statistically significant between the two groups at any corresponding time points (P>0.05) . In terms of imaging evaluation, there were adverse changes in Garden index, head -neck shortening and neck-shaft angle in both groups at the latest follow-up compared with those immediately postoperatively, which was not statistically significant in Garden indext (P> 0.05) , whereas statistically significant in head -neck shortening and neck-shaft angle (P<0.05) . There were no significant differences in abovementioned 3 items between the two groups at any corresponding time points (P>0.05) , additionally there was no significant difference in fracture healing time between the two groups (P>0.05) . [Conclusion] The new traction table does effectively reduce the positioning time and improve the operation efficiency.