青壮年股骨颈骨折股骨近端空心钉锁定钢板固定效果评价

 目的 评价青壮年股骨颈骨折股骨近端空心钉锁定钢板的固定效果。方法 2010-02至2012-08采用股骨近端空心钉锁定钢板治疗青壮年股骨颈骨折32例，男20例，女12例。其中高处坠落伤12例，交通事故伤 20 例，左髋18例，右髋14 例。PauwelsⅠ型12例，Ⅱ型20例，并发同侧股骨干骨折3 例。结果 术后患者切口均一期愈合。全部32例均获随访，随访时间12～24个月，平均17.2个月。1 例于术后 6 个月复查见股骨头缺血性坏死关节面塌陷，行人工全髋关节置换术;其余患者均获骨性愈合，愈合时间 6～12个月，平均8.2个月，未出现内固定物松动、断裂、患肢短缩等并发症。Harris评分术后6个月为(90.26±5.38)分与术前(38.63±8.26)分比较差异有统计学意义(t=6.56，P=0.02)。结论 股骨近端空心钉锁定钢板具有抗旋转力、抗剪切力、稳定性好、微创置入、骨质损失较少、股骨头血供破坏少、再血管化效果好等优势，在治疗青壮年股骨颈骨折方面具有一定的优势。

Analysis of proximal femoral tube screw locking plate (PF) for treatment of femoral neck fractures in 32 young adults

Objective To evaluate the clinical effect of proximal femoral tube screw locking plate for treatment of femoral neck fracture in young adults. Methods Thirty-two femoral neck fracture patients were treated by using femoral tube screw locking plate from February 2010 to August 2012. There were 20 males and 12 females with an average age of 31.5 years (17-44 years). Fracture was caused by falling from height in 12 cases and by traffic accident in 20 cases. All cases were fresh fracture. According to Pauwels criterion for typing, 12 cases were classified as type Ⅰ,20 cases as type Ⅱ and concurrent ipsilateral femoral fracture (3 cases).Results The patients were followed up for 12-24 months with an average of 17.2 months. One patients had avascular necrosis of femoral head and underwent artificial total hip replacement later. The remaining patients recovered smoothly in 6~12 months with an average of 8.2 months, did not develop looseness, breakage of internal fixation, and complications such as limb shortening, According to Harris criterion for hip joint function,the result was (90.26±5.38) points at 6 months postoperatively, compared with preoperative (38.63±8.26), the difference was statistically significant (t=6.56, P=6.56) Conclusion Proximal femoral tube screw locking plate has a rotating force, shear force resistance, good stability, minimally invasive placement, less bone loss, less blood supply damage of femoral head, an good revascularization effect; there fore, it has a certain advantage in the treatment of femoral neck fracture in young adults.