加压空心钉固定加肌蒂髂骨瓣移植联合治疗中青年股骨颈骨折

目的探讨加压空心钉固定加肌蒂髂骨瓣移植联合治疗中青年股骨颈骨折的疗效。方法加压空心钉固定加缝匠肌髂骨瓣和（或）阔筋膜张肌髂骨瓣植入治疗股骨颈骨折36例，观察骨折愈合率及优良率。结果36例均获随访，时间5—10（7．5±1．4）年。根据X线片和功能恢复程度并参考赵东升等标准进行功能评价：优27例，良7例，可2例，优良率为94．4％；骨折愈合时间3～8（5±1．6）个月，2例发生骨折不愈合，愈合率为94．4％。2例5年后股骨头坏死，坏死率为5．6％。结论加压空心钉固定加肌蒂骨瓣移植联合治疗中青年股骨颈骨折，固定牢固，缝匠肌髂骨瓣和（或）阔筋膜张肌髂骨瓣血供充足，可促进股骨颈骨折愈合，降低股骨头坏死率，提高疗效。

Treatment of femoral neck fracture with cannulated lag screws internal fixation and muscle-iliac flap graft in young adults

Objective To study the curative effect of cannulated lag screws internal fixation and muscle-iliac flap graft in treating femoral neck fracture in young adults. Methods 36 patients with femoral neck fractures were surgically treated by cannulated lag screws fixation plus transplantation of iliac flap of sartorius or/and tensor fascia lata. The healing rate and the satisfactory rate were observed. Results 36 cases were followed up for 5 - 10 （7.5 ± 1.4） years. According to the results of the X-ray and hip joint function evaluation and ZHAO Dong-sheng＇s clinical evaluation criteria ：27 got excellent function ,7 good ,2 fair, and the overall excellent and good rate was 94.4%. The bone union time was 3 - 8 （5 ± 1.6） months. Bone nonunion occurred in two cases, and the healing rate was 94.4%. Necrosis of femoral head occurred in 2 cases （ 5.6% ） after 5 years and necrosis rate was 5.6%. Conclusions Cannulated lag screws can provide stable fixation of femoral neck fracture in young adults. Transplantation of iliac flap of sartorius or/ and tensor fascia lata can provide enough blood supply and accelerate bone healing, reduce the rate of femoral head necrosis and improve curative effects.