空心钉内固定加缝匠肌髂骨瓣移植治疗青壮年股骨颈骨折

目的探讨应用空心钉内固定加缝匠肌髂骨瓣移植治疗青壮年股骨颈骨折的临床疗效。方法自2003年2月～2008年5月对应用空心钉内固定加缝匠肌髂骨瓣移植治疗38例青壮年股骨颈骨折。男性30例,女性8例;年龄16～54岁。致伤原因:道路交通伤16例,高处坠落伤11例,重物砸伤6例,摔伤5例。其中左侧21例,右侧17例。骨折部位:头下型12例,经颈型26例,按Garden分型:Ⅲ型22例,Ⅳ型16例。GardenⅡ型及基底型采用闭合复位,空心钉微创固定,无需切开骨瓣植骨。结果本组32例获得随访,参照张振兴等评定标准:优25例(78.1%),良5例(15.6%),差2例(6.2%);优良率93.7%。骨折愈合30例,愈合率为93.7%。结论空心钉内固定加缝匠肌髂骨瓣移植治疗青壮年股骨颈骨折有效的提高了骨折的愈合率,降低了股骨头缺血坏死的发生率。

Treatment of the femoral neck fracture by using the hollow screw internal fixation and the sartorial-pedicled ilium bone graft in young patients

Objective To discuss the clinical efficacy of using the hollow screw internal fixation and the sartorial-pedicled ilium bone graft in treating the femoral neck fracture among young people.Methods From Feb.2003 to May.2008,application of hollow screw internal fixation and sartorial-pedicled ilium bone graft was used to treat the femoral neck fracture in 38 young patients.There were 30 males,8 females,aging 16 to 54 years.Injury location： left side in 21 cases,right side in 17 cases.The causes of injury： traffic accident in 16 cases,falling from height in 11 cases,bruise in 6 cases,falling injury in 5 cases.Fracture site：head type in 12 cases,neck type in 26 cases.According to Garden classification： Ⅲ type in 22 cases,Ⅳ type in 16 cases.Garden Ⅱ type and basal type were treated with closed reduction and minimally invasive hollow screw fixation,without bone graft incision.Results Group of 32 patients were followed up.The clinical results were assessed according to evaluation standard described by Zhang zheng-xin,indicating excellent in 25 cases（accounting for 78%）,good in 5 cases（accounting for 15.6%）,poor in 2 cases（accounting for 6.2%）.The excellent rate was 93.7%.Totally 30 cases of fracture healed with healing rate of 93.7%.Conclusion The hollow screw internal fixation and the sartorial-pedicled ilium bone graft for the treatment of femoral neck fracture effectively enhance the healing rate of fractures,resulting in reducing the incidence of bone necrosis.