空心螺钉结合带旋股外侧动脉升支髂骨瓣与单纯空心螺钉内固定治疗青壮年股骨颈骨折的疗效比较

目的比较空心螺钉结合带旋股外侧动脉升支髂骨瓣与单纯空心螺钉内固定治疗青壮年股骨颈骨折的疗效。方法采用两种术式治疗股骨颈骨折78例。其中采用2枚空心螺钉内固定结合旋股外侧动脉升支髂骨瓣治疗40例(A组),单纯采用3枚空心螺钉内固定治疗38例(B组)。结果 78例均获3～9年随访。A组未见骨折不愈合病例,B组2例骨折不愈合,A组平均愈合时间(90.3±3)d,B组平均愈合时间(150.3±25)d。A组1例股骨头坏死,B组5例出现股骨头缺血坏死。两组末次随访时Harris评分比较差异无统计学意义(P>0.05)。结论应用2枚空心螺钉内固定结合带旋股外侧动脉升支髂骨瓣治疗青壮年股骨颈骨折具有再次手术率低,骨折不愈合率及骨坏死发生率低的优点。

Efficacy comparison between cannulated screw and internal fixations with iliac graft in treating femoral neck fractures in young adults

Objective To compare the effectiveness of two surgical approaches,internal fixations with or without iliac graft,on femoral neck fractures in young adults.Methods Seventy-eight patients were included in this study.The patients were randomized to undergo either internal fixation with two cannulated compression screws in combination with iliac graft supported by the ascending branch of circumflexa femoris lateralis(group A,n=40),or internal fixation alone with 3 cannulated compression screws(group B,n=38).Results During 3~9 years follow-up,the nonunion of patients was zero in group A and two case in group B.As shown in the final follow-up with surviving hips,the average healing time of fractures was(90.3±3)days in group A and(150.3±25)days in group B.One case of ONFH was observed in group A,and five cases were in group B.At last follow-up,there was no significant difference in Harris hip score between group A and group B.Conclusion Two cannulated compression screws in combination with iliac graft supported by the ascending branch of cirucumflexa femoris lateralis for treatment of young femoral neck fracture have the advantages of low re-operation rate,low nonunion rate and a low incidence of bone necrosis.