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1.
目的探讨空心加压螺钉内固定结合股方肌骨瓣移植治疗青壮年股骨颈骨折的临床疗效。方法采用髋关节后外侧切口,切开复位、空心加压螺钉内固定加股方肌骨瓣移植治疗青壮年股骨颈骨折26例。结果患者均获随访,时间1~3年。骨折均一期骨性愈合,疗效评定:优秀16例,良好8例,差2例,优良率达92.3%(24/26)。结论空心加压螺钉内固定结合股方肌骨瓣移植治疗青壮年股骨颈骨折骨愈合率高,并发症少,操作简单,恢复快,疗效好。  相似文献   

2.
目的探讨股方肌肌骨瓣移植结合空心螺钉内固定治疗青壮年股骨颈移位骨折的临床疗效。方法对28例有明显移位的青壮年股骨颈移位骨折行股方肌肌骨瓣移植结合空心螺钉内固定,并对患者的临床资料进行回顾性分析。结果 28例均获1.5~5年随访,平均3.5年。骨折愈合率96.6%,坏死率7%。结论股方肌肌骨瓣移植结合空心螺钉内固定治疗青壮年股骨颈移位骨折操作简单、愈合率高、并发症少,值得临床推广应用。  相似文献   

3.
目的探讨青壮年股骨颈骨折采用空心加压螺钉内固定联合股方肌肌骨瓣移植治疗的效果。方法收治30例GardenⅢ、Ⅳ型青壮年股骨颈骨折,均行空心加压螺钉内固定联合股方肌肌骨瓣移植治疗,对患者的临床资料进行回顾分析。结果 30例随访时间24~84个月,骨折愈合率96.7%,股骨头坏死率6.7%。结论空心加压螺钉内固定联合股方肌肌骨瓣移植是治疗青壮年股骨颈骨折的有效方法 。  相似文献   

4.
目的探讨联合应用股方肌骨瓣移植加空心加压螺钉内固定治疗青壮年股骨颈骨折的临床效果。方法经髋关节后外侧入路,取股方肌骨瓣移植于股骨颈骨折骨槽内,2~3枚空心加压螺钉内固定治疗22例青壮年股骨颈骨折。术后进行科学合理的功能锻炼。结果经1.5~5年(平均2年3个月)随访,20例4个月~1年均达到骨性愈合。2例股骨头缺血性坏死II期。按Harris髋关节功能评分:优14例,良6例,可2例,优良率达91%。结论应用股方肌骨瓣移植加空心加压螺钉内固定治疗股骨颈新鲜骨折,血供好,固定牢固,促进骨折愈合,减少股骨头坏死的发生,是治疗青壮年股骨颈骨折的有效方法。  相似文献   

5.
空心钉内固定加股方肌肌骨瓣移植治疗青壮年股骨颈骨折   总被引:16,自引:3,他引:13  
目的探讨青壮年股骨颈骨折采用空心钉内固定加股方肌肌骨瓣移植的疗效。方法采用Moore切口,股骨颈骨折行切开复位,空心加压螺纹钉内固定,股方肌肌骨瓣移植于股骨颈骨折处30例。结果随诊30例,时间3~5年,优良率96.6%,股骨颈骨折愈合率96.6%,股骨头缺血坏死率13.3%。结论空心钉内固定加股方肌肌骨瓣移植是治疗青壮年股骨颈骨折的有效方法。骨折愈合率高,坏死率低。  相似文献   

6.
股方肌骨瓣移植治疗青壮年股骨颈骨折   总被引:1,自引:0,他引:1  
目的探讨用股方肌骨瓣移植治疗青壮年股骨颈骨折的方法和疗效。方法采用股方肌骨瓣移植加螺钉内固定,治疗青壮年股骨颈骨折16例。结果术后随访1~3a,16例骨折均愈合,1例发生股骨头缺血性坏死。结论该术式能提高青壮年股骨颈骨折的愈合率,避免发生骨不连和股骨头缺血性坏死等严重并发症,是带蒂植骨治疗股骨颈骨折较好的手术方法。  相似文献   

7.
股方肌骨瓣移植治疗青壮年股骨颈骨折   总被引:2,自引:2,他引:0  
目的 探讨股方肌骨瓣移植治疗青壮年头下型和经颈型股骨颈骨折的疗效。方法 26例全部采用可折断螺钉固定加股方肌骨瓣移植。结果 26例随访时间3-8年,疗效评定按童星杰等制定的标准,优19例(73.1%)。良6例(23.1%)。差1例(3.8%)。结论 采用可折断螺钉固定股方肌骨瓣移植治疗青壮年头下型和经颈型股骨颈骨折,疗效较好。尤其适合于经颈型股骨颈骨折。  相似文献   

8.
目的探讨股方肌骨瓣加空心钉内固定治疗青壮年股骨颈骨折的临床应用价值及治疗效果。方法采用股方肌骨瓣加空心钉内固定治疗股骨颈骨折患者17例,男6例,女11例;年龄19~46岁,平均32岁。术后随访观察股骨颈骨折愈合及股骨头坏死的发生情况。结果本组17例均获得随访,随访时间0.5~5年。术后半年均有骨性愈合,1例术后2年出现股骨头缺血坏死,髋关节疼痛,活动稍有受限,16例股骨头完整,髋关节活动基本正常。结论股方肌骨瓣加空心钉内固定治疗青壮年股骨颈骨折,提高股骨颈骨折的愈合率,降低股骨头坏死的发生率。  相似文献   

9.
目的 探讨骨瓣移植治疗青壮年股骨颈骨折的临床疗效.方法 自2003年9月~2009年11月,本组共收治青壮年股骨颈骨折102例,其中采用带旋髂深血管髂骨瓣联合空心加压螺钉(A组)治疗31例,股方肌骨瓣联合空心加压螺钉(B组)治疗29例,缝匠肌骨瓣联合加空心加压螺钉(C组)治疗18例,单纯空心加压螺钉(D组)治疗24例....  相似文献   

10.
目的探讨中青年股骨颈骨折的治疗方法和临床治疗效果。方法自1998年1月~2004年12月收治中青年股骨颈骨折58例,其中GardenⅠ、Ⅱ型25例,GardenⅢ、Ⅳ型33例,采用3枚加压空心螺纹钉内固定加股方肌骨瓣转位移植治疗。结果所有病例均获随访,随访时间13~48个月,平均35个月。骨折全部愈合,愈合时间3~8个月,平均5个月,骨折愈合率100%,功能优良率91.4%;髋内翻2例,股骨头坏死2例。结论3枚加压空心螺纹钉内固定加股方肌骨瓣移植治疗中青年股骨颈骨折具有愈合时间短、骨折愈合率和功能优良率高等优点,是治疗中青年股骨颈骨折一种理想的方法。  相似文献   

11.
《Renal failure》2013,35(6):827-831
Bilateral femoral neck fractures are rarely reported in patients with end-stage renal disease before chronic dialysis. We report on a 39-year-old woman with neglected bilateral femoral neck fractures, who presented with severe uremic complications prior to chronic dialysis. Three years before admission, she had injured herself in a trivial slip with subsequent bilateral hip pain. She had progressively waddled since then. Pelvic X-ray taken after admission revealed bilateral femoral neck fractures. Bilateral hip hemiarthroplasties were subsequently performed. Displaced femoral neck fractures were found intraoperatively. Pathologic findings and results of examinations supported the coexistence of osteoporosis and high turnover renal osteodystrophy, rendering this woman at high risk of bilateral femoral neck fractures. Therefore, preventing a simple fall or trivial accident and treating renal osteodystrophy and osteoporosis are paramount in patients with chronic renal failure even before the start of dialysis therapy. We also emphasize the need to seek any possible underlying metabolic bone disease once a patient presents with unusual fractures.  相似文献   

12.
K H Hung  C T Lee  Y L Gau  J B Chen 《Renal failure》2001,23(6):827-831
Bilateral femoral neck fractures are rarely reported in patients with end-stage renal disease before chronic dialysis. We report on a 39-year-old woman with neglected bilateral femoral neck fractures, who presented with severe uremic complications prior to chronic dialysis. Three years before admission, she had injured herself in a trivial slip with subsequent bilateral hip pain. She had progressively waddled since then. Pelvic X-ray taken after admission revealed bilateral femoral neck fractures. Bilateral hip hemiarthroplasties were subsequently performed. Displaced femoral neck fractures were found intraoperatively. Pathologic findings and results of examinations supported the coexistence of osteoporosis and high turnover renal osteodystrophy, rendering this woman at high risk of bilateral femoral neck fractures. Therefore, preventing a simple fall or trivial accident and treating renal osteodystrophy and osteoporosis are paramount in patients with chronic renal failure even before the start of dialysis therapy. We also emphasize the need to seek any possible underlying metabolic bone disease once a patient presents with unusual fractures.  相似文献   

13.
Among 82 patients still alive after osteosynthesis of femoral neck fractures between 1974 and 1983, 67 (i.e. 81.7%) were controlled clinically and radiologically. The average follow-up period was 57.0 months. The average age of 36 men was 45.3 years, the average age of 31 women was 56.1 years. Fractures were divided in lateral and medial femoral neck fractures, the medial fractures were classified according to Pauwels and Garden. The rate of avascular head necrosis mounted 20.7%, the rate of non union 13.8%. Both complications were dependent on the type of fracture. Besides reduction and impaction of fragments time of operation proved to be important: In 37 fractures type Garden III and IV the rate of avascular head necrosis was 3-fold higher after secondary osteosynthesis than after emergency operation at the day of accident. Our concept in treatment of femoral neck fractures is based on these factors: Emergency operation, decompressive capsulotomy, valgus reduction, impaction of the fragments and internal fixation to allow movement.  相似文献   

14.
The Garden type I femoral neck fracture is defined as an incomplete fracture of the neck of the femur as seen on the antero-posterior (AP) radiograph of the injured hip. The diagnosis of incomplete femoral neck fractures has decreased in recent years with the development of improved radiographic imaging. We hypothesized that incomplete femoral neck fractures seen on radiographs are in fact complete fractures on computed tomography (CT). The study aims to test this hypothesis by comparing CT scan images to X-ray findings in patients diagnosed with Garden type I femoral neck fractures. From January 2008 to October 2010, our management of femoral neck fractures included a CT scan of the injured hip for all Garden type I fractures. CT findings were reported by a musculoskeletal radiologist. A classification of the fracture was performed by an orthopedic surgeon. Eight hundred and twenty five femoral neck fractures were admitted during the study period. Seventeen of these fractures (2.1%) were considered incomplete based on radiographic evaluation. In 17 cases (100%), the CT scan demonstrated a complete fracture extending through the medial cortex. Subsequently, all 17 fractures were fixed with standard cannulated screw technique on a fracture table. Secondary displacement occurred in one patient prior to fixation. All fractures healed well and no avascular necrosis was noted. In summary, our study shows that incomplete femoral neck fractures identified on X-rays are actually complete fractures based on CT scans. If confirmed by a larger study population, our findings can simplify the Garden classification by eliminating an inaccurate subcategory. The clinical implications are that Garden type I fractures should all likely be fixed with cannulated screws and with an effort to prevent displacement during treatment.  相似文献   

15.
D.S. Muckle  Z. Miscony 《Injury》1980,12(1):41-44
Eighty-six patients, aged under 60 years, who had sustained fractures of the femoral neck, were studied, as well as the circumstances of injury and the long term medication they may have had. They were divided into two groups: ‘injured’ (38), with an average age of 41 years, and the ‘uninjured’ (48), with an average age of 55 years. Unlike other series, the male to female ratio was equal.Trochanteric fractures were more common in men involved in high speed accidents and the prognosis was excellent, but subcapital fractures were most frequent in patients with concurrent illness and 77 per cent were taking drugs which could affect bone density. The prognosis in these relatively young patients with subcapital fractures was no different from that in much older patients: 28.5 per cent developed avascular necrosis and 21.4 per cent required prosthetic replacement.  相似文献   

16.
Treatment of undisplaced femoral neck fractures in the elderly   总被引:6,自引:0,他引:6  
Chen WC  Yu SW  Tseng IC  Su JY  Tu YK  Chen WJ 《The Journal of trauma》2005,58(5):1035-9; discussion 1039
BACKGROUND: While the treatment for displaced femoral neck fractures in the elderly (Garden types III and IV) is quite clear, the procedure for impacted or undisplaced femoral neck fractures (Garden types I and II) is still a subject of controversy. Methods: Thirty-seven (all >80 years old) patients with undisplaced femoral neck fractures were treated with osteosynthesis by cannulated screws fixation. The clinical outcomes were followed up retrospectively for at least two years. RESULTS: The overall union rate was 94.59% (35 patients) at 6 months after primary internal fixation. The overall success rate was 83.78% (31 patients), and the overall failure rate was 16.22% (6 patients). CONCLUSIONS: Osteosynthesis with cannulated screws fixation is a simple, safe, economical, and reasonably effective procedure for the treatment of undisplaced femoral neck fractures in patients older than 80 years.  相似文献   

17.
[目的]探讨股骨颈骨折空心钉固定术后空心钉脱出与并发症的关系.[方法]对2008年10月~2010年10月间于天津医院创伤骨科行内固定治疗的135例股骨颈骨折患者资料进行回顾性分析.男61例,女74例;年龄18~78岁,平均48.6岁.摔伤83例,车祸45例,其他损伤7例.按股骨颈骨折Garden分型:Ⅱ型9例,Ⅲ型75例,Ⅳ型51例.随访16~56个月,平均38.2个月.[结果]52例(38.5%)发生股骨颈短缩愈合;9例(6.7%)发生骨折不愈合;20例(14.8%)出现股骨头坏死;42例(31.1%)术后发生空心钉脱出,其中伴短缩愈合24例(46.2%)、不愈合6例(66.7%)、股骨头坏死12例(60%).术后空心钉脱出的发生与骨折Garden分型、骨质疏松Singh指数及骨折复位的Garden指数密切相关;且与骨折短缩愈合、骨折不愈合、股骨头坏死有密切关系.[结论]密切关注股骨颈骨折术后内固定的松动情况,防止空心钉过度脱出将有助于减少术后并发症,提高疗效.  相似文献   

18.
The late results of 133 operatively treated patients with femoral neck and trochanteric fractures were evaluated. The series consisted of 86 women and 47 men, 72 femoral neck fractures and 61 trochanteric fractures. 99 patients were treated by A-O osteosynthesis and 34 by endoprosthesis. The average age of the group with osteosynthesis was 71 and of the group with endoprosthesis 76 years. From 3 to 5 years after the operation the nailing results of the patients with femoral neck fractures were poor in 7.1 and with trochanteric fractures in 15.4 per cent. During the same observation period the results of the patients treated with endoprosthesis were poor in 14.3 per cent. There were no statistically significant difference between the A-O group and the endoprosthesis group with femoral neck fractures. Between the mortality of the nailed patients with femoral neck fractures and the endoprosthesis group there was no statistically significant difference.  相似文献   

19.
目的 探讨缝匠肌骨瓣移植术与加压螺纹钉在中青年股骨颈骨折中的应用及疗效。方法 1996年2月~2004年12月,对86例中青年股骨颈骨折患者采用开放复位、加压螺纹钉固定与缝匠肌骨瓣植骨进行治疗。年龄21~49岁,平均30.6岁。车祸伤35例,坠落伤27例,跌伤24例。骨折部位:头颈型33例,颈中型38例,基底型15例。骨折按Garden分型,Ⅱ型23例,Ⅲ型48例,Ⅳ型15例。术后观察x线片,分析骨折愈合情况并行功能评估。结果 62例获随访6个月~7年,平均2年5个月。骨折不愈合及股骨头坏死判断参照危杰等采用的标准,获随访的62例患者,4例发生骨折不愈合,骨折愈合率为93.5%;骨折愈合的患者中7例3年后发生股骨头坏死,发生率为11.3%。髋关节功能评定:优44例,良8例,可6例,差4例,优良率83.9%。骨瓣供区无功能障碍及不适。结论 缝匠肌骨瓣移植术与加压螺纹钉联合应用治疗中青年股骨颈骨折简便有效。  相似文献   

20.
In 1980 2449 patients with femoral neck and 1096 with trochanteric fractures were treated in Finland. The female--male ratio was 3:1 for femoral neck and 2:1 for trochanteric fractures. The age-specific incidence was higher for women than for men in both fracture types. About 3/4 of the patients were over 70 years old. The mean hospitalization time was 37 days for the patients with a femoral neck and 34 days for those with a trochanteric fracture. These patients accounted for 9% of all surgical hospitalization days in Finland during the year 1980. The injuries occurred evenly during every month. The number of femoral neck fractures will double during the period 1968 to 1985.  相似文献   

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