微创多枚空心加压螺钉固定治疗股骨颈骨折的疗效分析

【摘要】 目的 探讨微创多枚螺钉固定治疗股骨颈骨折的临床疗效。方法 对2008年8月~2010年8月于广州市第一人民医院创伤骨科及粤北人民医院关节外科采用闭合复位微创空心加压螺钉内固定治疗股骨颈骨折71例,对其随诊资料作回顾性的分析。患者包括男30例,女41例,年龄16~80岁,平均年龄62.4岁,全部为新鲜闭合性骨折。按股骨颈骨折Garden分型:Ⅰ型8例,Ⅱ型21例,Ⅲ型32例,Ⅳ型10例。随访时间14~60个月,平均31.5个月。结果 截至2012年8月,59例患者获骨性愈合,骨折平均愈合时间为5.1个月(3.6~11.3月),愈合率为83%;术后发生骨折不愈合,最终出现股骨头缺血性坏死12例(17%);髋关节功能按Harris评分:优良率84.7%;Garden Ⅰ、Ⅱ、Ⅲ、Ⅳ型的骨愈合率分别为100%、95.2%、78.1%、60%;Graden复位指数A、B、C组的愈合率分别为92.9%、77.3%、42.9%。结论 应用良好的牵引闭合复位和微创多枚空心加压螺钉内固定在治疗garden Ⅲ型以内的股骨颈骨折是一种疗效理想,操作简单、固定牢靠、创伤小的优良治疗方法。

Analysis of curative effects on minimally invasive hollow compression screws fixation for the treatment of femoral neck fracture

Objective To investigate the clinical effectiveness for treatment of femoral neck fracture by minimally invasive hollow compression screws fixation..Methods From Augest 2008 to Augest 2010,.71 cases with fresh neck fracture were treated by closed reduction and minimally invasive hollow compression screws fixation..And the clinical data of patients were analyzed retrospectively..Results As of August 2012,.59 patients achieved bone union with average 5.1 months after surgery..The healing rate was 83%.The nonunion or ischemic necrosis occurred in 12 cases（17%）..According to Harris hip score for the functional evaluation of hip joints,.the excellent and good rate was 84.7%.Garden Ⅰ,Ⅱ,Ⅲ,Ⅳ-type bone healing rates were 100%,.95.2%,.78.1%,60% respectively..Graden reset index A,.B,.C group healing rates were 92.9%,.77.3%,.42.9% respectively.Conclusion Using suitable closed reduction and hollow-compression screws fixation have an ideal outcome,simple manipulation,reliable fixation and less trauma for treatment of the femoral neck fracture within the Garden Ⅲ type.