目的 比较空心螺钉内固定术与DAA入路内侧支撑钢板辅助空心螺钉内固定术这两种手术方式治疗青壮年垂直不稳定型股骨颈骨折的近期疗效。方法 收集2016年4月—2018年2月23例中青年不稳定型股骨颈骨折患者,入院时随机分为空心螺钉内固定（A组,13例）、DAA入路内侧支撑钢板辅助空心螺钉内固定（B组,10例）治疗,对两组术中出血量,手术时间,术中透视次数,术后伤口感染、股骨头坏死与骨折不愈合等并发症的发生情况及术前、术后6个月Harris评分和VAS疼痛评分进行对比。结果 A组术中出血量[（73.85±12.10） mL]低于B组[（150.50±19.07） mL],A组手术时间[（53.85±10.24） min]低于B组[（86.00±12.65） min],A组术中透视次数[（1.85±0.69）次]少于B组[（4.50±1.08）次],差异有统计学意义（P<0.05）,B组术后6个月Harris评分及VAS疼痛评分均高于A组,差异具有统计学意义（P<0.05）。结论 DAA入路内侧支撑钢板辅助空心螺钉内固定术治疗中青年垂直不稳定型股骨颈骨折内固定,能稳定固定,髋关节功能恢复好。
Objective To compare the short-term effects of hollow screw internal fixation and medial support plate-assisted hollow screw internal fixation via DAA approach on vertically unstable femoral neck fractures in young and middle-aged adults. Methods From April 2016 to February 2018, 23 young and middle-aged patients with unstable femoral neck fractures were randomly divided into two groups at admission： hollow screw internal fixation group （group A, 13 cases） and DAA approach medial support plate-assisted hollow screw internal fixation group （group B, 10 cases）. The intraoperative bleeding volume, operation time, intraoperative fluoroscopy times, postoperative wound infection, necrosis of femoral head, and nonunion of fracture, as well as Harris score and VAS pain score before and 6 months after operation were compared between the two groups. Results The group A showed less intraoperative bleeding volume, shorter operation time, and fewer fluoroscopy times than the group B did [（73.85±12.10） mL vs. （150.50±19.07） mL, （53.85±10.24） min vs. （86.00±12.65） min, （1.85±0.69） vs. （4.50±1.08）] （P<0.05）. The group A also showed a lower Harris score and a lower VAS pain score than the group B 6 months after operation （P<0.05）. Conclusion The internal fixation assisted by medial support plate via DAA approach for vertically unstable femoral neck fractures in young and middle-aged patients can achieve stable fixation and good recovery of hip function.
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