老年新鲜股骨颈骨折治疗方法探讨

目的 探讨老年新鲜股骨颈骨折的术式选择。方法 回顾性分析217例60岁以上新鲜股骨颈骨折，分别采用单钉固定(46例)、多针固定(37例)、AO空心钉固定(79例)、人工髋关节置换(55例)4种方法，对比骨折愈合率、股骨头坏死率、髋关节功能恢复优良率。结果 内固定组骨折愈合率83．3％(140／162)，股骨头坏死率19．1％(31／162)，髋关节功能优良率75．9％(123／162)。其中空心钉组骨折愈合率94．9％(75／79)，股骨头坏死率6．3％(5／79)，髋关节功能优良率91.1％(72／79)。人工关节组髋关节功能优良率89．1％(49／55)。结论 内固定手术对老年新鲜股骨颈骨折有意义，AO空心钉固定操作简单，骨折愈合率高，可作首选内固定。人工髋关节置换应严格掌握适应证。

Treatment of the fresh femoral neck fractures of aged patients

Objective To explore the surgical methods in treatment of fresh femoral neck fractures in the elderly patients.Methods A retrospective analysis of different methods and res ults were made in 217 cases of fresh femoral neck frctures (over 60 years old).4 6 cases were with Smith-Peterson nail or compress screw,37 with multiple nails,7 9 with AO cannulated screw,and 55 with arthroplasty.Results Healing rate of 162 cases with internal fixation was 83.3%(140/162),avascular necrosis rate of femoral head 19.1%(31/162),excellen ce rate of the joint function 75.9%(123/162).In group of AO cannulated screw,he aling rate 94.9%(75/79),avascular necrosis rate of femoral head 6.3%(5/79),exc ellence rate of the joint function 91.1%(72/79) .Excellence rate of the joint f unction with arthroplasty 89.1%(49/55).Conclusion Internal fixation should be the the effective way to treat the femoral neck fracture for elderly patients.AO cannulated screw fixa tion is simple and solid fixation,and the injury is small,union rate is high.It could be the first choice.