关于国内中青年股骨颈骨折治疗的文献分析

目的通过对国内公开发表的关于中青年股骨颈骨折的所有文献资料进行汇总，从不同方面，就国内对于中青年股骨颈骨折的治疗情况进行统计学研究，并与外国文献报道的临床数据对比，以便于制定我国统一的中青年股骨颈骨折临床治疗指南。方法通过检索《中国生物医学文献数据库》等医学数据库，收集1985年12月至2009年2月国内发表的与中青年股骨颈骨折的相关文献。检索词主要是“中青年”、“股骨颈骨折”、“青壮年”等。同时采用手工检索及文献追溯的方法以确保收集完整。本研究特别采用两级制纳入标准。第一级纳入标准是：①研究对象年龄必须在18～55岁之间；②中文发表的文献。然后对它们进行数据抽取汇总和系统评价。结果共检索到191篇原始文献，经筛选和评价，最后搜集到91篇符合第一级纳人标准（一次文献）。随访资料完整的病例有1061例，分析显示：①目前国内中青年股骨颈骨折多数是由于车祸伤造成（56．63％）。②目前国内学者对于中青年股骨颈骨折，多数采用按骨折部位和Garden分型分型。③目前国内对于中青年股骨颈骨折治疗时机的把握上还做得不够，多在3天后。④目前国内学者多选择切开复位内固定加骨瓣移植治疗中青年股骨颈骨折（83．52％）。结论目前我国关于中青年股骨颈骨折治疗方面股骨头缺血坏死率，骨折不愈合率仍然较国外高，且许多文献中部分材料不详，一些临床标准在执行中不统一，给循证医学研究带来许多不利因素。

Treatment analysis of domestic femoral neck fracture in youths and the middle-aged

Objective From different but correlate aspects, Systematically collect and ana- lyze the treatment of domestic femoral neck fracture in youths and the middle-aged, in order to conduct the unified guideline. Methods To search the domestic literatures published from December 1985 to Feb- ruary 2009 about the treatment of domestic femoral neck fracture in youths and the middle-aged. Results After the screening and evaluation to the literatures according to the first level of inclusive criteria,191 published literatures were collected. There were a total of 1061 cases of patients. （1）The major cause of domestic femoral neck fracture in youths and the middle-aged is traffic accident（56.63%）. （2）Domestic scholars most according to the fracture site or the Garden＇s criteria to grade the femoral neck fracture （3）The date of surgery were most executed 3 days later, after the injury. （4）The rate of necrosis of the femoral head were still higher after the surgery ,in contrast to the foreign literatures .（5）Internal fixation with bone graft were popular adopted in the surgery for the femoral neck fracture in youths and the middle-aged（83. 52%）. Conclusion The rate of complications is still higher in contrast to the foreign literatures .also, Some unified criteria had not been executed in our literatures, this is a big disadvantage for the study of Evidencebased medicine.