骨软骨原位覆盖可吸收螺钉治疗股骨头骨折

目的总结骨软骨原位覆盖可吸收螺钉治疗股骨头骨折的效果。方法 28例股骨头骨折,按Pipkin分型：Ⅰ型8例,Ⅱ型13例,Ⅲ型1例,Ⅳ型6例。均采用骨软骨原位覆盖可吸收螺钉固定股骨头骨折;Ⅲ型骨折采用股骨近端支撑钢板固定股骨颈骨折;Ⅳ型骨折髋臼骨折片较小可去除,骨折片较大时可采用可吸收螺钉或重建钢板固定。结果所有患者术后无伤口感染发生,均伤愈出院。术后随访25例,平均随访25（2～63）个月,疗效评价：优16例,良5例,可3例,差1例。结论应用骨软骨原位覆盖可吸收螺钉治疗股骨头骨折突破了可吸收材料禁用于关节内骨折的禁忌,是一种实用、有效的方法。

Treatment of Femoral Head Fractures with Absorbable Screws Embedding under Cartilage

Objective To summarize the effect of osteochondral covering and absorbable screw internal fixation for treatment of femoral head fractures.Methods 28 femoral head fracture cases were treated by osteochondral covering and absorbable screw internal fixation,including of 8 of type Ⅰ,13 of type Ⅱ,1 of type Ⅲ and 6 of type Ⅳ according to Pipkin classification system.The femoral neck fractures of type Ⅲ were internal fixated by proximal femoral buttress plates;Smaller pieces of acetabular fractures of type Ⅳ were removed,and big pieces were fixated by absorbable screws or plates.Results All patients were discharged eventlessly without wound infection.25 cases were followed up for 2 to 63 months,with an average of 25 months.The outcome revealed excellence in 16 cases,good in 5 cases,fair in 3 cases and poor in 1 case.Conclusion The treatment of osteochondral covering and absorbable screw fixation is practical and effective for femoral head fractures of Pipkin typeⅠto Ⅳ,and can break through the usage taboo of absorbable screw in intra-articular fractures before.