84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]張忠良,林俊宏,費霖莉.代謝綜合征對股骨頸骨折空心螺釘內(nèi)固定術(shù)預(yù)后的影響[J].中醫(yī)正骨,2020,32(04):21-25.
　ZHANG Zhongliang,LIN Junhong,FEI Linli.Effects of metabolic syndrome on prognosis of patients who received surgery of hollow screw internal fixation for femoral neck fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(04):21-25.
點擊復(fù)制

代謝綜合征對股骨頸骨折空心螺釘內(nèi)固定術(shù)預(yù)后的影響()
分享到：

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年04期
頁碼:
21-25
欄目:
臨床研究
出版日期:
2020-04-20

文章信息/Info

Title:
Effects of metabolic syndrome on prognosis of patients who received surgery of hollow screw internal fixation for femoral neck fractures
作者:
張忠良; 林俊宏; 費霖莉
(金華市中醫(yī)醫(yī)院,浙江 金華 321017)
Author(s):
ZHANG Zhongliang; LIN Junhong; FEI Linli
Jinhua Hospital of Traditional Chinese Medicine,Jinhua 321017,Zhejiang,China
關(guān)鍵詞:
股骨頸骨折;  骨折固定術(shù); 內(nèi);  代謝綜合征X;  股骨頭壞死;  股骨頸短縮
Keywords:
femoral neck fractures;  fracture fixation; internal;  metabolic syndrome x;  femur head necrosis;  femoral neck shortening
摘要:
目的:探討代謝綜合征對股骨頸骨折空心螺釘內(nèi)固定術(shù)預(yù)后的影響。方法:回顧性分析2013年1月至2016年4月接受空心螺釘內(nèi)固定術(shù)治療的93例股骨頸骨折患者的病例資料,其中合并代謝綜合征者34例(代謝綜合征組)、無代謝綜合征者59例(無代謝綜合征組)。術(shù)后觀察骨折愈合情況,采用疼痛視覺模擬量表(visual analogue scale,VAS)評價髖部疼痛程度,采用Harris髖關(guān)節(jié)功能評分標(biāo)準(zhǔn)評價髖關(guān)節(jié)運動功能,根據(jù)髖關(guān)節(jié)MRI檢查結(jié)果評價股骨頭壞死情況,采用Mose圓心法計算股骨頸短縮長度(股骨頸短縮長度≤5 mm為無短縮、>5 mm為短縮)。結(jié)果:①骨折愈合情況。代謝綜合征組6例骨折不愈合,無代謝綜合征組5例骨折不愈合,2組骨折不愈合發(fā)生率的差異無統(tǒng)計學(xué)意義(χ2=1.740,P=0.187); 骨折不愈合者均拆除空心螺釘,行全髖關(guān)節(jié)置換術(shù)(total hip arthroplasty,THA)。②髖部疼痛及髖關(guān)節(jié)運動功能。排除骨折不愈合者,術(shù)后36個月,代謝綜合征組的髖部疼痛VAS評分高于無代謝綜合征組[(2.94±1.81)分,(2.11±1.43)分,t=2.356,P=0.021]、Harris髖關(guān)節(jié)功能評分低于無代謝綜合征組[(84.18±5.34)分,(88.39±5.78)分,t=3.257,P=0.002]。③股骨頭壞死。排除骨折不愈合者,術(shù)后36個月,代謝綜合征組9例出現(xiàn)股骨頭壞死,無代謝綜合征組7例出現(xiàn)股骨頭壞死,代謝綜合征組股骨頭壞死的發(fā)生率高于無代謝綜合征組(χ2=4.319,P=0.038); 股骨頭壞死患者后期均采用THA治療。④股骨頸短縮。排除骨折不愈合者,術(shù)后36個月,代謝綜合征組股骨頸短縮長度≤5 mm者7例、6～10 mm者12例、≥11 mm者9例,無代謝綜合征組股骨頸短縮長度≤5 mm者27例、6～10 mm者16例、≥11 mm者11例,無代謝綜合征組股骨頸短縮情況優(yōu)于代謝綜合征組(Z=-2.039,P=0.041); 代謝綜合征組股骨頸短縮的發(fā)生率高于無代謝綜合征組(χ2=4.748,P=0.029)。結(jié)論:代謝綜合征可影響股骨頸骨折空心螺釘內(nèi)固定患者的手術(shù)預(yù)后,術(shù)后髖部疼痛及功能障礙較為明顯,骨折愈合后股骨頭壞死及股骨頸短縮的發(fā)生率均較高,且股骨頸短縮程度相對嚴(yán)重。
Abstract:
Objective:To explore the effects of metabolic syndrome(MS)on prognosis of patients who received surgery of hollow screw internal fixation for femoral neck fractures.Methods:The medical records of 93 patients with femoral neck fractures who received surgery of hollow screw internal fixation from January 2013 to April 2016 were analyzed retrospectively,in which 34 patients had MS(MS group)and 59 patients had no MS(non-MS group).The fracture healing was observed after the surgery.The hip pain degree and hip motor function were evaluated by using pain visual analogue scale(VAS)scores and Harris hip scores respectively.The femur head necrosis was evaluated according to the results of MRI examination of hip,and the femoral neck shortening length was calculated by using Mose circle center method.The femoral neck shortening length of ≤5 mm was judged as non-shortening while that of >5 mm was judged as shortening.Results:The nonunion of fracture was found in 6 patients in MS group and 5 patients in non-MS group,and there was no statistical difference in the incidence rate of nonunion of fracture between the 2 groups(χ2=1.740,P=0.187).The hollow screws were removed and the total hip arthroplasty(THA)was performed on the patients with nonunion of fracture.At 36 months after the surgery,the hip pain VAS scores were higher and the Harris hip scores were lower in MS group compared to non-MS group except the patients with nonunion of fracture(2.94+/-1.81 vs 2.11+/-1.43 points,t=2.356,P=0.021; 84.18+/-5.34 vs 88.39+/-5.78 points,t=3.257,P=0.002).The femur head necrosis was found in 9 patients in MS group and 7 patients in non-MS group,and the incidence rate of femur head necrosis was higher in MS group compared to non-MS group(χ2=4.319,P=0.038).The patients with femur head necrosis were treated with THA in the later period.The femoral neck shortening length was ≤5 mm(7),ranged from 6 to 10 mm(12)and ≥11 mm(9)in MS group; while the femoral neck shortening length was ≤5 mm(27),ranged from 6 to 10 mm(16)and ≥11 mm(11)in non-MS group.The femoral neck shortening condition was better in non-MS group compared to MS group(Z=-2.039,P=0.041).The incidence rate of femoral neck shortening was higher in MS group compared to non-MS group(χ2=4.748,P=0.029).Conclusion:MS can affect the prognosis of femoral neck fractures after hollow screw internal fixation surgery.The patients always present with relatively obvious hip pain and dysfunction and relatively severe femoral neck shortening after the surgery,and the incidence rates of femur head necrosis and femoral neck shortening are relatively high after the fracture healing.

參考文獻(xiàn)/References:

[1] TIAN F M,ZHANG L,ZHAO H Y,et al.An increase in the incidence of hip fractures in Tangshan,China[J].Osteoporos Int,2014,25(4):1321-1325.
[2] 馮曉飛,余霄,龐清江.股骨頸骨折內(nèi)固定術(shù)后股骨頸短縮的臨床特點[J].中華骨與關(guān)節(jié)外科雜志,2018,11(5):364-369.
[3] HAIDER T,SCHNABEL J,HOCHPÖCHLER J,et al.Femoral shortening does not impair functional outcome after internal fixation of femoral neck fractures in non-geriatric patients[J].Arch Orthop Trauma Surg,2018,138(11):1511-1517.
[4] 劉祥,方紅育,黃濤,等.股骨頸骨折空心螺釘治療失敗因素的Meta分析[J].中華關(guān)節(jié)外科雜志(電子版),2018,12(4):73-82.
[5] SONG H K,CHOI H J,YANG K H.Risk factors of avascular necrosis of the femoral head and fixation failure in patients with valgus angulated femoral neck fractures over the age of 50 years[J].Injury,2016,47(12):2743-2748.
[6] VAN EMBDEN D,RHEMREV S J,GENELIN F,et al.The reliability of a simplified Garden classification for intracapsular hip fractures[J].Orthop Traumatol Surg Res,2012,98(4):405-408.
[7] 中華醫(yī)學(xué)會糖尿病學(xué)分會代謝綜合征研究協(xié)作組.中華醫(yī)學(xué)會糖尿病學(xué)分會關(guān)于代謝綜合征的建議[J].中華糖尿病雜志,2004,12(3):156-161.
[8] 嚴(yán)衛(wèi)鋒,曾忠友,裴斐.髖關(guān)節(jié)直接前方入路切開復(fù)位空心加壓螺釘內(nèi)固定治療難復(fù)位性股骨頸骨折[J].中醫(yī)正骨,2017,29(9):45-47.
[9] NILSDOTTER A,BREMANDER A.Measures of hip function and symptoms:Harris Hip Score(HHS),Hip Disability and Osteoarthritis Outcome Score(HOOS),Oxford Hip Score(OHS),Lequesne Index of Severity for Osteoarthritis of the Hip(LISOH),and American Academy of Orthopedic Surgeons(AAOS)Hip and Knee Questionnaire [J].Arthritis Care Res(Hoboken),2011,63 Suppl 11:S200-S207.
[10] 梁金龍.髖關(guān)節(jié)旋轉(zhuǎn)中心測量方法的研究進(jìn)展[J].中國矯形外科雜志,2014,22(6):512-515.
[11] WEIL Y A,QAWASMI F,LIEBERGALL M,et al.Use of fully threaded cannulated screws decreases femoral neck shortening after fixation of femoral neck fractures[J].Arch Orthop Trauma Surg,2018,138(5):661-667.
[12] 洪寶建,梁麗娟,李忠浩,等.代謝綜合征老年男性患者骨代謝物和骨密度的關(guān)系研究[J].中華全科醫(yī)學(xué),2014,12(5):723-724.
[13] NISHIKAWA A,ISHIDA T,TAKETSUNA M,et al.Safety and effectiveness of daily teriparatide in a prospective observational study in patients with osteoporosis at high risk of fracture in Japan:final report[J].Clin Interv Aging,2016,11:913-925.
[14] 柏茂盛,趙建寧,洪葉.脂代謝與骨代謝信號通路及與骨代謝相關(guān)疾病的關(guān)系:理論進(jìn)展與熱點方向[J].中國組織工程研究,2018,22(20):3269-3274.
[15] 池達(dá)智,陳江,羅晶,等.血脂異常對股骨頸骨折術(shù)后股骨頭缺血性壞死的診斷價值[J].重慶醫(yī)學(xué),2014,43(1):30-32.
[16] WONGDEE K,KRISHNAMRA N,CHAROENPHANDHU N.Derangement of calcium metabolism in diabetes mellitus:negative outcome from the synergy between impaired bone turnover and intestinal calcium absorption[J].J Physiol Sci,2017,67(1):71-81.
[17] DOMINGUETI C P,DUSSE L M,CARVALHO M D,et al.Diabetes mellitus:the linkage between oxidative stress,inflammation,hypercoagulability and vascular complications[J].J Diabetes Complications,2016,30(4):738-745.
[18] 王斌,鐘浩博,楊劍鋒.3種內(nèi)固定治療PauwelsⅢ型股骨頸骨折的生物力學(xué)研究[J].中醫(yī)正骨,2018,30(7):6-9.
[19] 李磊,朱晨,方詩元,等.股骨頸骨折空心釘內(nèi)固定術(shù)后長期療效分析[J].中華關(guān)節(jié)外科雜志(電子版),2018,12(3):10-15.
[20] HIRAKAWA Y,NAKAMURA H,MINAMITANI K,et al.Prognostic value of the sliding length of cephalocervical screws to predict the risk of non-union after osteosynthesis:a retrospective analysis of 86 patients with intracapsular femoral neck fractures[J].J Orthop Surg Res,2017,12(1):33.
[21] ZLOWODZKI M,JÖNSSON A,PAULKE R,et al.Shortening after femoral neck fracture fixation:is there a solution?[J].Clin Orthop Relat Res,2007,461:213-218.
[22] SLOBOGEAN G P,STOCKTON D J,ZENG B F,et al.Femoral neck shortening in adult patients under the age of 55 years is associated with worse functional outcomes:analysis of the prospective multi-center study of hip fracture outcomes in China(SHOC)[J].Injury,2017,48(8):1837-1842.
[23] STOCKTON D J,LEFAIVRE K A,DEAKIN D E,et al.Incidence,magnitude,and predictors of shortening in young femoral neck fractures[J].J Orthop Trauma,2015,29(9):e293-e298.
[24] SCHWEITZER D,MELERO P,ZYLBERBERG A,et al.Factors associated with avascular necrosis of the femoral head and nonunion in patients younger than 65 years with displaced femoral neck fractures treated with reduction and internal fixation[J].Eur J Orthop Surg Traumatol,2013,23(1):61-65.
[25] 柴斌,李康養(yǎng),丁文彬,等.股骨頸骨折空心加壓螺釘內(nèi)固定術(shù)后股骨頭壞死的原因分析[J].中國骨與關(guān)節(jié)損傷雜志,2017,32(2):182-184.
[26] 唐路平,李偉軍,熊炎,等.65歲以下股骨頸骨折術(shù)后股骨頭壞死的多因素分析[J].中國矯形外科雜志,2013,21(6):538-541.
[27] ZENG X,ZHAN K,ZHANG L,et al.The impact of high total cholesterol and high low-density lipoprotein on avascular necrosis of the femoral head in low-energy femoral neck fractures[J].J Orthop Surg Res,2017,12(1):30.

相似文獻(xiàn)/References:

[1]溫超海,何忠,李永斌,等.閉合復(fù)位伽瑪釘改良成鎖定支架內(nèi)固定治療 老年股骨轉(zhuǎn)子間骨折[J].中醫(yī)正骨,2015,27(11):32.
[2]肖善富,張喜善,于鳳珍.髕下小切口鋼絲紐扣式內(nèi)固定治療脛骨髁間隆突骨折[J].中醫(yī)正骨,2015,27(11):34.
[3]朱峰,宋相建,吳蔚,等.手法復(fù)位經(jīng)皮克氏針內(nèi)固定治療 兒童閉合性肱骨遠(yuǎn)端全骨骺分離[J].中醫(yī)正骨,2015,27(11):51.
[4]裘人華,胡培陽,裘天強(qiáng),等.閉合復(fù)位外固定架固定治療Colles骨折[J].中醫(yī)正骨,2015,27(11):59.
[5]葛波涌,王玉波,王明太,等.交鎖髓內(nèi)釘內(nèi)固定治療脛骨干骨折的臨床研究[J].中醫(yī)正骨,2015,27(10):8.
　GE Boyong,WANG Yubo,WANG Mingtai,et al.Clinical study on the internal fixation with interlocking intramedullary nail for the treatment of tibial shaft fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(04):8.
[6]鄧紅敏,劉志誠.轉(zhuǎn)子間斜行截骨結(jié)合股骨近端防旋髓內(nèi)釘固定治療 股骨近端骨折術(shù)后髖內(nèi)翻畸形[J].中醫(yī)正骨,2015,27(10):17.
[7]孫群周,阮成群,李光明,等.股骨近端防旋髓內(nèi)釘內(nèi)固定治療 老年不穩(wěn)定型股骨轉(zhuǎn)子間骨折[J].中醫(yī)正骨,2015,27(10):20.
[8]方策,倪新宇,王宏偉,等.遲氏正骨手法復(fù)位單臂外固定支架固定治療 老年股骨轉(zhuǎn)子間骨折[J].中醫(yī)正骨,2015,27(10):22.
[9]全先輝,萬春友,劉磊,等.Taylor空間支架外固定治療脛腓骨開放性骨折[J].中醫(yī)正骨,2015,27(10):30.
[10]茆軍,張惠法,嚴(yán)培軍,等.Ilizarov外固定支架結(jié)合克氏針固定治療Pilon骨折[J].中醫(yī)正骨,2015,27(10):32.
[11]劉震,胡志國,付偉.抖牽旋按復(fù)位結(jié)合鋼針撬撥復(fù)位空心釘內(nèi)固定治療 難復(fù)性股骨頸骨折[J].中醫(yī)正骨,2015,27(08):28.
[12]林統(tǒng),徐強(qiáng),包海燕.閉合復(fù)位經(jīng)皮空心加壓螺釘內(nèi)固定聯(lián)合口服中藥 治療股骨頸骨折[J].中醫(yī)正骨,2015,27(07):61.
[13]陳武林,阮成群.縫匠肌肌蒂髂骨骨瓣移植聯(lián)合股骨近端外側(cè)鎖定鋼板固定治療青壯年股骨頸骨折不愈合[J].中醫(yī)正骨,2017,29(02):41.
[14]嚴(yán)衛(wèi)鋒,曾忠友,裴斐.髖關(guān)節(jié)直接前方入路切開復(fù)位空心加壓螺釘內(nèi)固定治療難復(fù)位性股骨頸骨折[J].中醫(yī)正骨,2017,29(09):45.
[15]王斌,鐘浩博,楊劍鋒.3種內(nèi)固定治療PauwelsⅢ型股骨頸骨折的生物力學(xué)研究[J].中醫(yī)正骨,2018,30(07):6.
　WANG Bin,ZHONG Haobo,YANG Jianfeng.A biomechanical study of three kinds of internal fixation for treatment of Pauwels typeⅢfemoral neck fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(04):6.
[16]李少帥,張宏軍.PauwelsⅢ型股骨頸骨折內(nèi)固定方式的選擇及常見問題探討[J].中醫(yī)正骨,2018,30(11):57.
[17]王淼鑫,袁西岐,鄭作超,等.股骨近端鎖定鈦板內(nèi)固定治療股骨頸骨折[J].中醫(yī)正骨,2018,30(11):68.
[18]范克杰,陳柯,田可為,等.手法閉合復(fù)位聯(lián)合平行螺釘和偏軸螺釘內(nèi)固定治療青壯年垂直不穩(wěn)定型股骨頸骨折[J].中醫(yī)正骨,2020,32(07):47.
[19]丁強(qiáng),劉玉峰,蘇藝,等.克氏針與空心螺釘內(nèi)固定治療兒童DelbetⅡ、Ⅲ型股骨頸骨折[J].中醫(yī)正骨,2020,32(11):69.
[20]楊曉強(qiáng),薛繼釗,鄭程,等.青壯年股骨頸骨折的內(nèi)固定治療進(jìn)展[J].中醫(yī)正骨,2021,33(07):38.
　YANG Xiaoqiang,XUE Jizhao,ZHENG Cheng,et al.Advancement of treatment of femoral neck fractures with internal fixation in young adults[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(04):38.

備注/Memo

備注/Memo:
(收稿日期:2019-09-03 本文編輯:郭毅曼)
更新日期/Last Update: 2020-07-31