闭合复位空心钉内固定加股方肌骨瓣转移术治疗股骨颈骨折

目的目前对青壮年有移位新鲜股骨颈骨折患者的治疗仍存在许多争议,被认为尚未完全解决难题之一,股骨颈骨折内固定术后常导致骨折不愈合股骨头缺血性坏死。方法 2003年1月2008年6月,收治青壮年新鲜移位股骨颈骨折患者12例,年龄17～55岁,平均36.3岁。所有患者在受伤后1周内采用牵引下闭合复位空心钉内固定加股方肌骨瓣移植术治疗。术后随访1～5年,平均3.5年。结果 12例患者均达骨性愈合,随访期内未出现股骨头缺血性坏死;术后采用Harris髋关节评分标准进行评估,获优良10例,一般1例,差1例。结论青壮年新鲜有移位股骨颈骨折患者,采用牵引下闭合复位空心钉内固定加股方肌骨瓣转移术治疗效果良好,均能达到骨折愈合,且无股骨头缺血性坏死发生。

Femoral Neck Fracture Treated with Close Reduction plus Cannulated Screw Fixation with Quadratus Femoris Muscle Pedicle Bone Grafting

Objective Management of fresh displaced femoral neck fracture in young patients remain controversy,and is still considered as an unsolved problem. For this fracture often result in nonunion or vascular necrosis of femoral head. Methods From January 2003 to June 2008 we operated 12 young patients of fresh displaced femoral neck fracture in the age group of 17 to 55 years,mean age of 36.3 years. The patients were operated within one week of injury. Closed reduction under traction plus cannulated screws fixation along with quadratus femoris muscle pedicle bone grafting were done in all cases. They were followed up for an average period of 3.5 years （range 1-5 years）. Results Results were assessed according to modied Harris Hip Scoring system and found to be excellent in 10,good in 1,fair in 1. Bony union occurred in 12 cases,no patient developed vascular necrosis （AVN） till date. Conclusion For fresh displaced femoral neck fracture in young patients,closed reduction under traction、cannulated screws fixation along with quadratus femoris muscle pedicle bone grafting is a suitable option to secure union and prevent development of AVN.