林晓聪 蔡礼权 方凯彬 戴章生

【摘要】 目的：探讨青年股骨颈骨折内固定术后股骨短缩的发生情况，以及中期随访时股骨短缩与功能之间的关系。方法：选取2014年1月-2016年12月采用闭合复位空心钉内固定治疗的29例股骨颈骨折患者作为研究对象。在术后3个月及1年进行站立位X线检查，了解股骨短缩及功能情况。结果：术后3个月时有17例发生股骨短缩，股骨短缩发生率为58.6%，术后3个月平均短缩（7.5±1.3）mm。术后1年进行复查时，发生短缩的病例数一般没有进一步增加;术后1年平均短缩（9.1±2.1）mm。股骨短缩患者與非股骨短缩患者年龄、性别、致伤原因、手术时间、入院至入手术室时间、HHS评分、VAS评分、UCLA评分比较差异均无统计学意义（P>0.05）;股骨短缩患者与非股骨短缩患者Garden分型、AO-OTA分型、Pauwells角、BMI比较，差异有统计学意义（P<0.05）。结论：采用内固定治疗的青年股骨颈骨折患者虽然在中期随访中股骨短缩的发生率较高，但未发现股骨颈短缩对患肢功能有明显影响。

【关键词】 股骨短缩 股骨颈骨折 青年

doi：10.14033/j.cnki.cfmr.2020.13.006 文献标识码 B 文章编号 1674-6805（2020）13-00-04

Analysis of the Relationship between Femur Shortening and Function Effects after Internal Fixation of Femoral Neck Fractures in Youth/LIN Xiaocong， CAI Liquan， FANG Kaibin， DAI Zhangsheng. //Chinese and Foreign Medical Research， 2020， 18（13）： -19

[Abstract] Objective： To investigate the occurrence of femur shortening after internal fixation of femoral neck fracture in youth and the relationship between femur shortening and function during mid-term follow-up. Method： A total of 29 patients with femoral neck fracture treated with closed reduction cannulated internal fixation from January 2014 to December 2016 were selected as the research objects. Standing X-ray examination was performed at 3 months and 1 year postoperatively to understand femur shortening and function. Result： Femur shortening occurred in 17 patients 3 months after the operation， with an incidence of 58.6%， and an average shortening was （7.5±1.3） mm 3 months after the operation. At the time of reexamination 1 year after the operation， the number of cases with shortening generally did not increase further. The average shortening was （9.1±2.1） mm 1 year after the operation. There were no statistically significant differences in age， gender， cause of injury， operation time， admission to the operating room， HHS score， VAS score and UCLA score between patients with femoral shortening and patients without femoral shortening （P>0.05）. There were statistically significant differences between the two groups in Garden classification， AO-OTA classification， Pauwells angle， BMI between patients with femoral shortening and patients without femoral shortening （P<0.05）. Conclusion： Although the incidence of femoral shortening in young patients with femoral neck fracture treated by internal fixation is high in the mid-term follow-up， there is no significant effect of femoral neck shortening on limb function.

[Key words] Femoral shortening Femoral neck fracture Youth

First-authors address： The Second Affiliated Hospital of Fujian Medical University， Quanzhou 362000， China

股骨颈骨折是骨科日常创伤治疗中最常见的骨折。全世界每年有160万股骨颈骨折患者[1]。既往有研究表明空心钉锁定钢板具有固定可靠、退钉率低、骨折愈合率较高等优势，是治疗青壮年股骨颈骨折的一种有效方法[2]。王峰等[3]发现采用螺钉F形固定技术治疗股骨颈骨折，临床效果满意，术后并发症发生率较低。但股骨颈骨折采用空心螺钉闭合内固定因其手术时间短、出血少、术后住院时间短、早期下床活动等优点，仍为临床医师治疗股骨颈骨折常选择的手术方式。多数股骨颈骨折患者为老年人，但仍有3%～10%的股骨颈骨折发生在青年患者中。由于……