股骨颈骨折两种治疗方法的比较

目的　探讨闭合复位内固定与切开复位内固定治疗股骨颈骨折的疗效、各自优缺点及最佳适应症。方法　将 98例股骨颈骨折患者随机分为两组 ,分别采用闭合复位内固定术及切开复位内固定术治疗。其中闭合复位组 56例 ,切开复位组 42例。结果　经 1～ 5年 ,平均 2 6年的随访。闭合复位组 :治愈 33例 ,好转 2 0例 ,未愈 3例 ;切开复位组 :治愈 2 1例 ,好转 1 9例 ,未愈 2例。两种治疗方法临床效果无统计学差别 (P >0 0 5)。结论　对能闭合复位满意的新鲜股骨颈骨折 ,闭合复位内固定应视为有效、可靠的首选方法 ;对陈旧性股骨颈骨折及股骨颈骨折颈后骨质粉碎缺损、经复位后对位又不满意者 ,则应首选切开复位内固定结合带蒂骨瓣移植治疗

Comparison of two methods for the treament of femoral neck fractures

Objective:To investigate the effect and the indications for the treatment of the femoral neck fractures with closed and open reduction fixation Methods:98 patients with femoral neck fractures were divided into two groups randomly,56 cases with closed reduction and internal fixation and 42 cases with open group,with respective adoption of the treatment of internal fixations of closed and open reduction and internal fixation.Results:After 1 to 5 years follow up (average 2 6 years),33 are cured,20 improved and 3 uncured in closed group.21 are cured,19 improved and 2 uncured in open group.There is no significant differences between the two Methods(P>0.05).Conclusion:The closed reduction should be selected firstly for the treatment for fresh femoral neck fractures.The combined internal fixation and muscle pedicle bone grafts should be used for the treatment of old femoral neck fractures with communicated fragments or posterior defects and unsatisfied closed reduction.