回旋法微创进路股骨头置换术治疗股骨颈骨折

目的：探索一种简便、有效的手术进路行人工股骨头置换术治疗股骨颈骨折。方法：在采用髋关节后外侧手术进路基础上,不通过切断臀中、小肌及股外旋肌群来显露术野,而是仅切断股方肌后,利用股骨颈骨折形成假关节异常活动,采取回旋手法,来充分显露股骨大、小粗隆及髋关节。作者从2009年1月-2013年6月采用此入路行人工股骨头置换术治疗股骨颈骨折22例。结果：全组患者无手术死亡及术后感染、骨折与血管神经损伤等并发症,术后随访6-12个月,总优良率为95.4%,其中3例患者术后发生轻度跛行,1例患者患肢短缩达到2cm,1例下肢静脉血栓形成,无术后髋关节脱位病例。结论：作者认为此手术进路有操作简便、安全、微创、缩短手术时间、出血少、术后功能恢复快等优点,是一种可行的手术方法,可供同道参考。

Treating transcervical fracture by artificial femoral head replacement through roundabout method minimally invasive approach

Objective： To explore a convenient and effective approach for artificial femoral head replacement on femoral neck fracture. Methods： Artificial femoral head replacement was excised through the posterolateral approach of hip joint. The approach was safeguarded middle and minimal gluteal muscle and extorsion musculation of thigh. Only switch off musculi quadvatus femoris and adopt convolution technique in line with abnormal movement from nearthrosis of femoral neck fractures to expose greater and lesser trochanter and the hip. From January 2009 to June 2013, 22 cases were treated by artificial femoral head replacement through this approach. Results： There were no death in operation, infection after operation, fracture and vascular nerve injury. After operation 6- 12 months, the excellent rate was 95.4%. Among them, 3 cases were slight limping, 1 case with limb shortening reached 2cm, 1 case with legs DVT, without postoperative hip dislocation. Conclusion： Process was confirmed with simple and convenient, safe, minimally invasive, time-saving, less blood loss and quick postoperative recovery. It could be used for surgical procedures and reference.