闭合复位空心螺钉固定治疗中老年股骨颈骨折的临床疗效观察

目的:观察闭合复位空心螺钉内固定治疗中老年股骨颈骨折的临床疗效。方法:采用闭合复位空心螺钉内固定治疗中老年股骨颈骨折30例。其中男21例,女9例,年龄50~91岁,平均68.7岁。摔伤15例,坠落伤5例,交通伤10例。无移位骨折21例,移位骨折9例。按照Garden分型:Ⅰ型13例,Ⅱ型8例,Ⅲ型5例,Ⅳ型4例。结果:本组病例随访1~3.5年,平均2.5年,2例出现骨折不愈合,其余骨折均愈合,平均愈合时间5个月。术后2年内2例出现股骨头缺血性坏死。髋关节功能根据评分标准,优14例,良11例,差5例,优良率83.3%。结论:闭合复位空心螺钉内固定是治疗中老年股骨颈骨折的一种有效方法,操作简单,疗效满意,骨折愈合率高,且能降低股骨头坏死发生率。

Treatment of femoral neck fracture in the elders by closed reduction and internal fixation using cannulated screws

Objective To evaluate the therapeutic effect of closed reduction and internal fixation using cannulated screws on femoral neck fracture in the elders.Method Thirty patients suffered from femoral neck fracture were treated by closed reduction and cannulated cancellous screws internal fixation.There were 21 males and 9 females,with mean age of 68.7 years old（range from 50 to 91 years old）.Mechanisms of injury included falling（15 cases）,falling from height（5 cases）,and traffic accident（10 cases）.According to the classification of Garden,thirteen patients belong to typeⅠ,8 patients to type Ⅱ,5 patients to type Ⅲ and 4 patients to type Ⅳ.Results The mean time of follow-up period was 2.5 years（range from 1 to 3.5 years）.All patients but 2 cases were finally healed,and the average of fracture union time was 5 months.Two patients developed ischemic necrosis of femoral head in 2 years postoperatively.Accordingly,the hip joint function was excellent in 14 cases,good in 11 cases and bad in 5 cases.The healing rate was 83.3%.Conclusion Closed reduction and cannulated screws internal fixation,with simple procedure and satisfactory effect,is an effective method to treat femoral neck fractures in the elders.It can enhance fracture union and reduce incidence of avascular necrosis of femoral head.