经关节囊穿针引导复位空心钉内固定治疗股骨颈骨折的临床观察

目的：分析和探讨经关节囊穿针引导复位空心钉内固定治疗股骨颈骨折的疗效。方法将重庆市第五人民医院骨科收治的50例股骨颈骨折患者按随机数字表法随机分为观察组和对照组，观察组使用经关节囊穿针引导复位空心钉内固定，对照组使用切开复位空心钉进行固定。将两组患者的疗效进行对比和分析。结果观察组患者骨折愈合的平均时间为5个月，1例骨折不愈合，占4％；2例股骨头坏死，占8％；术后12个月髋关节 Harris评分，优11例，良7例，可4例，差3例，优良率达72％。对照组患者愈合平均时间为6个月，6例骨折不愈合，占24％；8例股骨头坏死，占32％；术后12个月髋关节 Harris评分，优8例，良6例，可7例，差4例，优良率为56％。结论经关节囊穿针引导复位空心钉内固定术治疗股骨颈骨折与切开复位内固定术相比创伤小、痛苦少、保证了关节囊的完整性、不损害神经血管、并发症发生率较低、患者的制动时间相对较短、疗效显著，值得临床推广使用。

Clinical observation of the joint capsule needle guide reset cannulated screw fixation of femoral neck fracture

Objective To analyze and discuss the effect of guiding the needle through the joint capsule reset cannulated screw fixation of femoral neck fracture .Methods 50 cases of femoral neck fracture patients admitted to our hospital orthopedic random number table ,randomly divided into observation group and control group ,the observation group using the joint capsule needle guide reset and cannulated screw internal fixation ,and the control groups using oper reduction cannulated screw fixation .Compare and analyze the efficacy of the two groups .Results The mean time to fracture healing in observation group was 5 months ,1 case of nonunion ,accounted for 4% ;2 cases of femoral head necrosis ,accounted for 8% ;12 months after operation ,accounted to Harris hip score ,11 cases were excellent ,7 cases ,4 cases were fair and 3 cases were poor ,good rate was 72% .The average healing time of patients in the control group was six months ,six cases of nonunion ,accounted 24% ;8 cases of osteonecrosis ,accounted for 32% ;Harris hip score at 12 months after operation ,8 cases were excellent ,6 cases were good ,7 cases were fair ,4 cases were poor , good rate was 56% .Conclusion The joint capsule needle guide reset cannulated screw fixation of femoral neck fracture compared with internal fixation incision has less trauma ,less pain ,ensuringthe integrity of the joint capsule ,without prejudice to the neurovascular ,lower complication rate ,shorter braking time and significant effect is worthy of clinical use .