空心钉锁定板治疗中青年不同类型股骨颈骨折临床疗效

目的：探讨空心钉锁定板治疗中青年不同类型股骨颈骨折的临床疗效。方法2009年10月～2011年9月采用牵引复位，空心钉锁定板内固定治疗65例不同类型股骨颈骨折；GardenⅠ型6例，Ⅱ型10例，Ⅲ型29例，Ⅳ型20例；术后1、2、3、6、12个月门诊随访复查，观察骨折（内固定）位置，骨折愈合，股骨头缺血坏死，髋关节功能情况。结果术后伤口均Ⅰ期愈合；随访时间12～30个月，平均18个月；骨折不愈合4例（Garden Ⅲ型1例，Ⅳ型3例），股骨头缺血坏死7例（Garden Ⅲ型1例，Ⅳ型2例，继发骨不愈合4例），骨折愈合时间6～11.2个月，平均9个月；未见骨折移位、内固定断裂松动等情况；Harris评分术前（40.83±9.27）分，术后（89.39±6.29）分，髋关节功能较术前明显恢复，差异有统计学意义。结论空心钉锁定钢板具有固定牢固，骨折愈合率高等优势，治疗中青年Garden Ⅰ、Ⅱ、Ⅲ型股骨颈骨折效果确切。

Clinical efficacy of cannulated screw locking plate in the treatment of different types of femoral neck fracture in young and middle-aged patients

Objective To summarize and analyze the clinical efficacy of cannulated screw locking plate in the treatment of different types of femoral neck fracture in young and middle-aged patients.Methods 65 patients with different types of femoral neck fracture were treated via tractive reduction and internal fixation of cannulated screw locking plate from October 2009 to September 2011.There were 38 male patients and 27 female ones,with the ages of 19-60 years and the average of 43.5 years.6 patients belonged to Garden type I,10 typeⅡ,29 typeⅢ and 20 type IV. Outpatient follow-ups were carried out 1 month,2 months,3 months,6 months and 12 months after the surgery,and fracture position （internal fixation）,fracture recovery,avascular necrosis of femoral head and function of hip joint were observed.Results All wounds recovered at stage I after the surgery;the follow-ups lasted 12-30 months,with the average of 18 months; fracture nonunion was seen in 4 patients （1 Garden typeⅢ and 3 type IV）,avascular necrosis of femoral head was seen in 7 patients（1 Garden typeⅢ,2 type IV,and 4 secondary nonunion）,and fracture recovery time was 6-11.2 months,with the average of 9 months;no displaced fracture and loosened or broken internal fixation were seen;Harris score was（40.83±9.27） before the surgery and （89.39±6.29） after the surgery,showing that the function of hip joint improved significantly compared to that before the surgery,and the difference was statistically significant. Conclusion Cannulated screw locking plate has the advantages of firm fixation and high fracture recovery,and has an exact curative effect in the treatment of Garden Ⅰ,Ⅱ and Ⅲ femoral neck fracture in young and middle-aged patients.