富血小板血浆联合中空螺钉内固定治疗股骨颈骨折

目的探讨自体富血小板血浆(PRP)联合中空螺钉内固定治疗股骨颈骨折的近期临床疗效。方法回顾性分析2012年5月至2018年5月期间漯河医学高等专科学校第二附属医院采用中空螺钉内固定治疗的160例股骨颈骨折患者资料。根据是否采用PRP配合治疗分为两组(n=80):PRP组男46例,女34例;年龄为(52.3±7.6)岁;骨折Garden分型:Ⅰ型1例,Ⅱ型5例,Ⅲ型57例,Ⅳ型17例;采用中空螺钉内固定联合PRP治疗。对照组男41例,女39例;年龄为(50.6±7.3)岁;骨折Garden分型:Ⅰ型2例,Ⅱ型7例,Ⅲ型51例,Ⅳ型20例;采用中空螺钉内固定治疗。记录并比较两组患者的骨折愈合时间、骨不连和股骨头缺血性坏死发生率及髋关节Harris评分等。结果两组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。160例患者术后获12~36个月随访。PRP组患者的骨折愈合时间(4.3±1.0)个月]显著短于对照组患者(7.3±1.3)个月],术后骨不连发生率0%(0/80)]、股骨头缺血性坏死发生率3.8%(3/80)]显著低于对照组患者7.5%(6/80)、15.0%(12/80)],差异均有统计学意义(P<0.05)。PRP组患者术后6、12个月髋关节Harris评分分别为(88.7±5.3)、(94.2±4.8)分,均显著高于对照组患者(81.4±4.6)、(84.2±5.2)分],差异均有统计学意义(P<0.05)。结论与单纯中空螺钉内固定相比,PRP联合中空螺钉内固定治疗股骨颈骨折能明显缩短患者骨折愈合时间,降低股骨头缺血性坏死的发生率,提高髋关节功能。

Platelet-rich plasma combined with hollow screw fixation for femoral neck fractures

Objective To study the curative effect of platelet-rich plasma(PRP)combined with internal fixation with hollow screws on femoral neck fractures.Methods The clinical data of 160 patients with femoral neck fracture were retrospectively analyzed who had been treated by internal fixation with hollow screws at Orthopedic DepartmentⅢ,The Second Affiliated Hospital to Luohe Medical College from May 2012 to May 2018.According to whether PRP was used or not to assist their internal fixation,they were divided into a PRP group(n=80)and a control group(n=80).In the PRP group,there were 46 males and 34 females with an age of 52.3 years±7.6 years,and one case of typeⅠ,5 cases of typeⅡ,57 cases of typeⅢand 17 cases of typeⅣby the Garden classification.In the control group,there were 41 males and 39 females with an age of 50.6 years±7.3 years,and 2 cases of typeⅠ,7 cases of typeⅡ,51 cases of typeⅢand 20 cases of typeⅣby the Garden classification.The 2 groups were compared in terms of fracture healing time,nonunion,femoral head necrosis and Harris hip scores.Results The 2 groups were comparable because their preoperative general data showed no significant differences(P>0.05).The 160 patients obtained follow-up for 12 to 36 months.The PRP group showed significantly shorter fracture healing time(4.3 months±1.0 months),significantly lower incidences of nonunion0%(0/80)]and avascular necrosis of femoral head3.8%(3/80)]than the control group7.3 months±1.3 months,7.5%(6/80)and 15.0%(12/80),respectively](all P<0.05).The Harris scores at 6 and 12 months after operation for the PRP group(88.7±5.3 and 94.2±4.8)were significantly higher than those for the control group(81.4±4.6 and 84.2±5.2)(both P<0.05).Conclusion In the treatment of femoral neck fractures,compared with internal fixation with hollow screws alone,platelet rich plasma combined with internal fixation with hollow screws can significantly shorten fracture healing time,reduce incidence of avascular necrosis of the femoral head and improve functional recovery of the hip joint.