股方肌骨瓣移植加压空心螺钉内固定治疗股骨颈骨折临床分析

目的探讨股方肌骨瓣移植加压空心螺钉内固定术治疗股骨颈骨折的疗效。方法本组58例患者均采用髋关节后外侧切口．用骨刀凿取4．0cm×2．0cm×1．0cm带血管蒂股方肌蒂骨瓣，直视下骨折解剖复位，三枚空心螺钉内固定。将带血管蒂骨瓣移至股骨头颈处，可吸收丝线缝合。结果患者随访时间12-18个月，平均15个月，58例患者骨折全部愈合，优35例，良18例，可2例，差3例，优良率为91．37％，无股骨头坏死发生。结论带血管蒂股方肌骨瓣移植加压空心螺钉治疗股骨颈骨折操作可行性强、血供好、愈合时间短、骨折愈合率和功能优良率高，能提高股骨颈骨折的治愈率，有效预防股骨头坏死，是治疗股骨颈骨折的有效方法。

with internal fixation by hollow-compression-screw in the treatment of femoral neck fracture

Objective To investigate the effect of quadratus femoris muscle pedicle bone graft combined with internal fixation by hollow-compression-screw in the treatment of femoral neck fracture. Methods In all the 58 cases, vascu- larized muscle bone flap of quadratus for 4.0 cm×2.0 cm×1.0 cm was removed from hip posterolateral incision, then fracture anatomical reduction was achieved under direct vision, and internally fixed with three cannulated screw, vas- cularized bone nap was transplanted to femoral neck, and sutured with absorbable suture line. Results The mean fol low-up time was 15 （12-18） months, fracture healing in 58 cases, excellent in 35 cases, good in 18 cases, fair in 2 cas- es, poor in 3 cases. The excellent and good rate was 91.37%. No case occurred femoral head necrosis. Conclusion Quadratus femoris muscle pedicle bone graft combined with intemal fixation by hollow-compression-screw is an ef- fective method in the treatment of femoral neck fracture, because of good feasibility, good blood supply, short healing time, high healing rate and high rate of excellent and good function. It can improve the cure rate of femoral neck frac- ture, and can effectively prevent femoral head necrosis.