旋髂深血管蒂髂骨瓣植骨治疗青壮年陈旧性股骨颈骨折的临床分析

目的探索青壮年陈旧性股骨颈骨折的治疗新思路,分析带旋髂深血管蒂髂骨瓣植骨治疗股骨颈骨折的可行性。方法分析该院收治的股骨颈患者46例,年龄25～55岁,患者入院均为受伤后采用保守治疗或其他手术方式愈合不良患者。研究采用带旋髂深血管蒂髂骨瓣植骨治疗。随访患者术后24～48个月,平均40个月,对比治疗前后的不同治疗方法的愈合效果及Harris评分。结果治疗后随访,患者骨折愈合效果明显改善,治疗前传统手术及治疗方式总有效率为2.17%,治疗后总有效率为97.83%。评价治疗前后髋关节功能及活动效果,治疗前Harris评分平均为65.14分,治疗后平均为95.68分。结论带旋髂深血管蒂髂骨瓣植骨治疗股骨颈骨折可以利用青壮年血运丰富的优势,为骨折端提供丰富的营养和血液供应,恢复效果好,髋关节功能不受影响。

The Clinical Analysis of Deep Vascular Pedicle Iliac Bone Graft in Treatment of Old Femoral Neck Fracture in Young Adults

Objective To analyze the feasibility of deep vascular pedicle iliac bone graft in the treatment of old femoral neck fracture in young adults so as to find a new way to treat the disease. Methods Clinical data of 46 patients with old femoral neck fracture, aged from 25～55, admitted in our hospital were analyzed. Before the admission, all of them had adopted conservative treatment or other surgical procedures after injury, but the healing was poor. They were treated with deep vascular pedicle iliac bone graft. The patients were followed for 24 ～48 months, average 40 months. The healing effects before and after the treatment were compared evaluated by Harris hip score. Results After the treatment, the healing effects of the patients were improved obviously. Before the treatment, the total effective rate was 2.17%, Harris score was 65.14 on average, after the treatment, the total effective rate was 97.83%, and Harris score was 95.68. Conclusion Taking the advantage of rich blood supply of young adults, deep vascular pedicle iliac bone graft can provide rich nutrition and blood for the fracture end in the treatment of femoral neck fracture. And the recovery of the patients is good; their hip joint functions are not affected.