复位质量对中青年股骨颈骨折经闭合复位空心螺钉内固定治疗效果的影响.doc

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1、复位质量对中青年股骨颈骨折经闭合复位空心螺钉内固定治疗效果的影响蒋海涛卢海源左文山徐勇蔡伟江苏淮安市第一人民医院摘要:冃的:研究复位质量对中青年股骨颈骨折经闭合复位空心螺钉内固定治疗效果的影响。方法：回顾性分析我院收治的86例股骨颈骨折中青年患者临床资料，所有患者均行闭合复位空心螺钉内同定治疗，术后根据Garden对线指数分级对患者复位质量进行评价，其中『I级59例设置为A组，IIIF级27例设置为B组，比较两组患者术后骨折不愈合、股骨头缺血性坏死发生率以及Harris^关节功能评分情况，比较两组患者术后血清神经元特异性烯醇化酶(NSE)、

2、C-反应蛋白(CRP)、血清基质金屈蛋白酶-9(MMP-9)指标水平。结果:A组患者骨折不愈合率为6.78%较B组22.22%显著较低，A组股骨头缺血性坏死率为8.47%较B组25.93%显著较低;A组患者疼痛、功能、畸形、活动范围及Harris总分较B组均显著较高M组患者术后血清NSE、CRP、MMP-9指标水平较B组显著较低。结论:复位质量是影响股骨颈骨折经闭合复位空心螺钉内固定手术治疗疗效的原因之一，复位质量越高，骨折不愈合及股骨头缺血性坏死发生率显著降低，有利于患者预后。关键词：复位质量;股骨颈骨折；内固定;疗效;作者简介：蔡伟，E

3、-mail:xzmccaiwei@163.com收稿日期：2017-07-16Effectofreductionqualityontheeffectsofclosedreductionandcannulatedscrewfixationinyoungandmiddle-agedpatientswithfemoralneckfracturesJiangHai-taoLuHai-yuanZuoWen-shanXuYongCaiWeiDepaxtmentofOrthopedics,theFirstPeople'sHospitalofHuai'an

4、;Abstract：ObjectiveTostudytheeffectofreductionqualityontheeffectsofclosedreductionandcannulatedscrewfixationinyoungandmiddle-agedpatientswithfemoralneckfractures.MethodsTheclinicaldataof86youngandmiddle-agedpatientswithfemoralneckfracturesinourhospitalwereretrospectivelyan

5、alyzed.Allpatientsweretreatedbyclosedreductioiiandcannulatedscrewfixation.AccordingtotheGardenlineindexgrading,thereductionqualitywasevaluated.59casesofgradeI11wereincludedintogroupAand27casesofgradeIII"wereincludedintogroupB.Theincidenceratesofnonunion,ischemicnecrosisoff

6、emoralhead,Harrishipscores,levelsofserumneuronspecificenolase(NSE),C-reactiveprotein(CRP)andserummatrixmetal1oproteinase_9(MMP一9)werecomparedbetweenthetwogroups.ResuItsTheincidenceratesofnonunionandischemicnecrosisoffemoralheadingroupAwerelowerthanthatingroupB(6.78%and8.47

7、%vs22.22%and25.93%).Thepain,function,deformity,rangeofmotionandHarrisscoresingroupAweresignificantlyhigherthanthoseingroupB.The1evelsofserumNSE,CRPandMMP~9ingroupAafteroperationweresignificantlylowerthanthoseingroupB.ConclusionThereductionqualityisoneofthefactorsinfluencin

8、gtheeffectsofclosedreductionandcannulatedscrewfixationinyoungandmiddle一agedpatieiitswithf