肖芳繁 胡婷 吴敏 肖磊 邹贵骞

*基金项目：赣州市科技计划项目（GZ2021ZSF115）

【摘要】 目的：探讨微创空心钉内固定联合富血小板血浆（PRP）技术在中青年股骨颈头下型骨折中的治疗效果。方法：回顾性纳入2021年12月—2022年6月于赣南医学院第二附属医院住院的80例股骨颈头下型骨折患者，按照治疗方式不同将患者分为观察组（n=38）、对照组（n=42）。观察组采用微创空心钉内固定术联合PRP技术治疗方案，对照组采用微创空心钉内固定术治疗方案。比较两组住院时长、骨折愈合时间及术后并发症发生情况，对比两组术前及术后24、72 h疼痛程度[数字分级评分法（NRS）]、术后6个月骨折愈合情况（Fernandez-Esteve骨痂评分）及术后1年髋关节恢复优良率（Harris髋关节功能评分）。结果：观察组住院时长、骨折愈合时间均短于对照组（P<0.05）；观察组术后并发症总发生率低于对照组（7.89% vs 26.19%）（P<0.05）；术后24、72 h，两组NRS评分均降低，且观察组NRS评分均低于对照组（P<0.05）；观察组Fernandez-Esteve骨痂评分高于对照组（P<0.05）；两组髋关节恢复优良率比较，差异无统计学意义（P>0.05）。结论：微创空心钉内固定联合PRP技术治疗中青年股骨颈头下型骨折，可加速骨折的修复愈合，减少并发症，减轻疼痛感，髋关节功能恢复效果良好。

【关键词】 微创空心钉内固定 血小板血浆技术 中青年 股骨颈头下型骨折

Clinical Study of Minimally Invasive Hollow Screw Internal Fixation Combined with PRP Technique in the Treatment of Subcapital Femoral Neck Fracture in Young-and-middle Age Patients/XIAO Fangfan， HU Ting， WU Min， XIAO Lei， ZOU Guiqian. //Medical Innovation of China， 2024， 21（13）： 0-096

[Abstract] Objective： To explore the effect of minimally invasive hollow screw internal fixation combined with platelet rich plasma （PRP） technique in the treatment of subcapital femoral neck fracture in young-and-middle age patients. Method： A total of 80 patients with subcapital femoral neck fracture admitted to the Second Affiliated Hospital of Gannan Medical College from December 2021 to June 2022 were retrospectively included and were divided into observation group （n=38） and control group （n=42） according to different treatment methods. The observation group was treated with minimally invasive hollow screw internal fixation combined with PRP technique， and the control group was treated with minimally invasive hollow screw internal fixation. Length of stay， fracture healing time and postoperative complications were compared between the two groups. The pain degree [numerical rating scale （NRS）] before operation and 24 h and 72 h after operation， fracture healing situation （Fernandez-Esteve callus score） at 6 months after operation， excellent and good rate of hip recovery （Harris hip function score） at 1 year after operation were compared between the two groups. Result： The length of stay and postoperative healing time in observation group were shorter than those in control group （P<0.05）. The total incidence rate of postoperative complications in observation group was lower than that in control group （7.89% vs 26.19%） （P<0.05）. 24 and 72 h after operation， NRS scores in both groups were decreased， and NRS scores in observation group were lower than those in control group （P<0.05）. The Fernandez-Esteve callus score of observation group was higher than that of control group （P<0.05）. There was no significant difference in the excellent and good rate of hip recovery between the two groups （P>0.05）. Conclusion： Minimally invasive hollow screw internal fixation combined with PRP technique in the treatment of subcapital femoral neck fracture in young-and-middle age patients can accelerate the repair and healing of fractures， reduce complications， relieve pain， and achieve good hip functional recovery.

[Key words] Minimally invasive hollow screw internal fixation PRP technique Young-and-middle age Subcapital femoral neck fracture

First-author's address： Department of Orthopaedics， the Second Affiliated Hospital of Gannan Medical College， Xinfeng 341600， China

doi：10.3969/j.issn.1674-4985.2024.13.021

股骨颈骨折为临床常见的骨折类型，是指股骨头下至股骨颈基底部位的骨折，中青年股骨颈骨折多因车祸及暴力等高能量创伤导致，表现为骨折端明显移位，血供破坏严重，常伴有骨质粉碎和缺损[1]。目前临床多采取人工关节置换、闭合/切开复位内固定等手术方式，依据骨折类型及患者年龄、活动需求及基础疾病选择适宜治疗方案，但在保证固定后稳定性及恢复股骨头血供方面的疗效尚有提升[2]。……