| 3枚不平行螺钉固定技术治疗股骨颈骨折的疗效分析 |
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Received:June 25, 2012
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| 作者 | Author | 单位 | Unit | E-Mail |
| 张国柱 |
ZHANG Guo-zhu |
北京积水潭医院创伤骨科,北京 100035 |
Department of Orthopaedics, Jishuitan Hospital, Beijing 100035, China |
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| 王满宜 |
WANG Man-yi |
北京积水潭医院创伤骨科,北京 100035 |
Department of Orthopaedics, Jishuitan Hospital, Beijing 100035, China |
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| 蒋协远 |
JIANG Xie-yuan |
北京积水潭医院创伤骨科,北京 100035 |
Department of Orthopaedics, Jishuitan Hospital, Beijing 100035, China |
jxy0845@sina.com |
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| 期刊信息：《中国骨伤》2012年25卷，第12期，第1002-1004页 |
| DOI：10.3969/j.issn.1003-0034.2012.12.008 |
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目的：探讨3枚不平行空心钉技术治疗股骨颈骨折患者的临床疗效。
方法：2008年9月至2009年5月,29例患者参与本方法治疗。其中男12例,女17例;年龄27～62岁,平均52岁。术前采用Garden系统分型:GardenⅡ型(无移位骨折)2例,GardenⅢ型18例(有移位骨折),GardenⅣ型(有移位骨折)9例。术中骨折复位后,再按照Pauwels系统分型:Ⅱ型12例,Ⅲ型17例。采用闭合复位,3枚不平行空心钉或全螺纹松质骨螺钉固定术进行治疗。手术当日X线片与随访X线片比较观察有无股骨颈短缩及螺钉退出的表现。采用Harris评分系统对随访结果进行功能评价。
结果：本组均获随访,时间34～44个月,平均38个月。骨折愈合时间3～12个月,平均7个月。4例骨折不愈合,均为Garden Ⅳ型,其中2例出现股骨头坏死。Harris评分:2例无移位骨折患者均为100分;27例有移位骨折者中,23例为骨折愈合且无股骨头缺血坏死,Harris评分平均(91.35±8.00)分,4例骨折不愈合者Harris评分平均(61.23±5.12)分。除1例外,28例术后随访均未出现股骨颈短缩表现。
结论：不平行螺钉治疗股骨颈骨折可以有效控制股骨颈骨折愈合后短缩及螺钉尾部退出等。 |
| [关键词]:骨折固定术,内 股骨颈骨折 骨折愈合 |
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| Three nonparallel screws for the treatment of femoral neck fractures |
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Abstract:
Objective:To explore clinical effects of three nonparallel screws in treating femoral neck fractures.
Methods:From September 2008 and May 2009,29 patients were treated,including 12 males and 17 females with an average age of 52 years (ranged from 27 to 62 years). Before operation,according to Garden classification system,2 cases were Garden type Ⅱ (undisplaced fracture) ,18 cases were Garden type Ⅲ (partial displaced fracture) and 9 cases were Garden type Ⅳ(complete displaced fracture). After fracture reduction in operation,Pauwels classification system was used to classify the type,and 12 cases were type Ⅱ,17 cases were type Ⅲ Closed reduction and internal fixation with three non-parallel screws were used to treat. The surgery X-ray and follow-up X-ray were compared to observe whether femoral neck abbreviate and screw exit appeare. Harris scoring was used to evaluate function.
Results:All patients were followed-up from 34 to 44 months with an average of 38 months. The mean time of bone union was 7 (ranged,3 to 12) months. Nonunion occured in 4 cases with Garden Ⅳ,and femoral head necrosis occurred in 2 cases. For Harris scoring,two cases with nondisplaced fracture were 100. Among 27 cases with displaced fractures,23 cases achieved bone union without femoral head necrosis,average Harris scale was 91.35±8.00,and the average Harris scale of 4 cases with bone nonunion was 61.23±5.12. For all but one,there was no femoral neck crispation after bone union.
Conclusion:Nonparallel screws for femoral neck fractures can effectively control abbreviation and screw tail exit after fracture healing. |
| KEYWORDS:Fracture fixation,internal Femoral neck fractures Fracture healing |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张国柱,王满宜,蒋协远.3枚不平行螺钉固定技术治疗股骨颈骨折的疗效分析[J].中国骨伤,2012,25(12):1002~1004 |
| 英文格式: | ZHANG Guo-zhu,WANG Man-yi,JIANG Xie-yuan.Three nonparallel screws for the treatment of femoral neck fractures[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(12):1002~1004 |
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