空心螺钉联合三维蜂窝导向器定位植钉治疗老年股骨颈骨折的临床效果

doi:10.3969/j.issn.1003-9198.2023.07.013

Abstract

Abstract: Objective To investigate the effect of cannulated screw combined with different positioning screw implantation strategies on the accuracy of screw implantation, hip function score (Harris) and the complications in the treatment of femoral neck fractures in the elderly. Methods A total of 104 elderly patients with femoral neck fractures admitted to our hospital from April 2017 to April 2021 were enrolled and divided into two groups by random number table method, with 52 patients in each group. All patients underwent percutaneous hollow screw internal fixation, and the patients receiving freehand positioning of the nail implant were divided into group B and those receiving new 3D foveal guide assisted positioning of the nail implant were divided into group A. The data of perioperative indexes, imaging indexes, stress hormones, Harris score, visual analogue scale (VAS) score and the complications were collected and compared between the two groups. Results The accuracy rate of screw implantation was significantly higher and the number of guiding needle punctures was significantly lower in group A than those in group B (P＜0.05). Immediately after operation, the parallelism between screws, the axial deviation between screws and neck and the screw coverage area in group A were lower than those in group B, and the distance between screws was greater than that in group B (P＜0.01). The serum levels of cortisol and norepinephrine in group A were lower than those in group B 1 d after operation (P＜0.05). There was no significant difference in Harris and VAS scores between the two groups before operation, 6 months and 12 months after operation (P>0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusions The new three-dimensional honeycomb guide-assisted positioning of the screw and the free-hand screw implantation show similar effects in the treatment of femoral neck fractures in the elderly patients. The former helps to improve the accuracy of screw implantation and imaging indicators, with less stress response.

Key words: aged, femoral neck fracture, percutaneous cannulated screw fixation, three-dimensional honeycomb guide

CLC Number:

R 683.42

SHEN Lin-hua, CAI Cheng-ming, WEI Chen, SHI Ben-hai, DONG Yu-qing. Effects of cannulated screw combined with three-dimensional honeycomb guide in the treatment of elderly patients with femoral neck fractures[J]. Practical Geriatrics, 2023, 37(7): 700-704.

References

[1] KAMARA E, ZVI Y S, VAIL T P, et al. Treatment of valgus-impacted and nondisplaced femoral neck fragility fractures in the elderly[J]. J Am Acad Orthop Surg, 2021, 1(11):470-477.
[2] FISCHER H, MALEITZKE T, EDER C, et al. Management of proximal femur fractures in the elderly current concepts and treatment options[J]. Eur J Med Res, 2021, 4(1):86.
[3] 余霄, 张迪峰, 宋蒙胜, 等. 骨质疏松性股骨颈骨折空心钉内固定术后股骨颈短缩对髋关节生物力学影响的有限元分析[J]. 中华医学杂志, 2020, 100(33):2628-2632.
[4] WAN L, ZHANG X, WU D, et al. Application of robot positioning for cannulated screw internal fixation in the treatment of femoral neck fracture:retrospective study[J]. JMIR Med Inform, 2021, 21(1):e24164.
[5] 易少华, 张德华, 王健, 等. 机器人导航辅助经皮空心钉内固定治疗股骨颈骨折的临床疗效评价[J]. 中国骨与关节损伤杂志, 2022, 37(4):337-341.
[6] CHENG Q H, LI P B, LU T T, et al. Computer-assisted cannulated screw internal fixation versus conventional cannulated screw internal fixation for femoral neck fractures:a systematic review and meta-analysis[J]. J Orthop Surg Res, 2021, 22(1):687.
[7] 陈孝平, 汪建平. 外科学[M]. 8版. 北京:人民卫生出版社, 2013:676-683.
[8] 张鹏, 张迪, 李向科, 等. 降钙素原水平与髋关节结核病变严重程度及预后的相关性研究[J]. 河北医科大学学报, 2020, 41(4):405-408.
[9] 刘陆伟, 王春生. 温针灸联合神经松动术治疗神经根型颈椎病的临床效果, 颈椎活动度及对VAS评分的影响[J]. 解放军医药杂志, 2021, 33(2):97-100.
[10] ZHANG R Y, ZHAO Y P, SU X Y, et al. The oval-like cross-section of femoral neck isthmus in three-dimensional morphological analysis[J]. Orthop Surg, 2021, 13(1):321-327.
[11] 赵梁, 陈蕾, 宋卫, 等. 骨折精确复位与限量负重管理预防股骨颈骨折空心钉内固定术后股骨头缺血性坏死[J]. 中国骨与关节损伤杂志, 2021, 36(2):156-158.
[12] 吴江红. 新型导向器应用于股骨颈骨折空心螺钉置入术的可行性和有效性研究[D]. 上海:中国人民解放军海军军医大学, 2019.
[13] 高峰, 吴晓峰, 徐锋, 等. 新型三维蜂窝导向器在股骨颈骨折经皮空心钉内固定中的临床应用[J]. 中国修复重建外科杂志, 2022, 36(1):65-70.
[14] AIBINDER W R, YUAN B J, CROSS W W, et al. Sequential fluoroscopic rollover images reliably identify "in-out-in" posterosuperior screws during percutaneous fixation of femoral neck fractures[J]. Eur J Orthop Surg Traumatol, 2020, 30(6):1061-1065.
[15] 房明岗, 刘杏. 七氟烷静吸复合麻醉对老年髋关节骨折手术患者应激反应,免疫功能及术后镇静的影响[J]. 临床误诊误治, 2020, 33(1):70-74.
[16] 彭印文, 李永军, 崔邦胜, 等. 骨水泥型与生物型假体半髋置换治疗老年股骨颈骨折的创伤程度及骨代谢比较[J]. 中国骨质疏松杂志, 2020, 26(10):1514-1518.

Effects of cannulated screw combined with three-dimensional honeycomb guide in the treatment of elderly patients with femoral neck fractures

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