带旋髂深血管髂骨瓣联合空心加压螺钉治疗股骨颈骨折50例疗效观察

目的观察带旋髂深血管髂骨瓣联合空心加压螺钉治疗股骨颈骨折的疗效。方法选取自2010年1月至2011年10月我院收治的股骨颈骨折患者100例，将其作为研究对象，随机分为观察组和对照组各50例。其中对照组患者仅单独采用空心加压螺钉进行股骨骨折的处理，观察组在对照组的基础上联合带旋髂深血管髂骨瓣进行治疗。术后跟踪随访20个月，观察并比较两组患者的疗效。结果观察组髋关节功能恢复优良率、骨折愈合率分别为90％、100％，均明显高于对照组；观察组术后骨折愈合时间早于对照组，且Harris髋关节评分较对照组高；观察组患者术后并发症的总发生率为10％，明显低于对照组的40％，以上各项指标比较差异均具有统计学意义（P〈0．05）。结论带旋髂深血管髂骨瓣联合空心加压螺钉联合治疗股骨颈骨折的疗效较好，其能保证骨折端血运得以重建，从而促进患者骨折断端的愈合，骨折愈合率高于单独固定治疗，且股骨头缺血坏死发生较少，可作为股骨骨折手术的首选手段。

Effect of vascular pedicled iliac flap combined with hollow compression screw on 50 cases of transcervical fracture

Objective To observe the clinical effect of vascular pedicled iliac flap combined with hollow compression screw on transcervical fracture. Methods One hundred cases of transcervical fracture admitted to our hospital from January 2010 to October 2011 were selected and randomly divided into observation group and control group with 50 cases in each one. Hollow compression screw was used alone in control group while a combination with vascular pedicled iliac flap was performed in observation group. After 20 months of follow-up, the effects in both two groups was observed and compared. Results The excellent and good rate of hip function and the fracture healing rate in observation group were 90% and 100% respectively, which were significantly higher than those in control group. Compared with those in control group, the time of fracture healing after operation in observed group was earlier and the Harris hip score was higher. The total complication rate after operation in observation group was 10%, which was significantly lower than that in control group with 40%. All differences above had statistical significances （P〈0.05）. Condusion The effect of vascular pedicled iliac flap combined with hollow compression screw was bet- ter in treating transcervical fracture. It ensured reconstruction of blood supply to the fracture ends so as to promote the healing. Meanwhile, it was characterized as higher fracture healing rate than separate fixation and less occurrence of avascular necrosis of the femoral heads, which can be the first choice in the femoral fracture operation.