双螺旋加压螺纹钉内固定治疗股骨颈骨折愈后影响因素分析

目的对应用2枚中空双螺旋加压螺纹钉内固定治疗股骨颈骨折愈后情况进行回顾性总结,分析骨折类型、复位质量、年龄及手术时间等因素与股骨头缺血坏死和晚期塌陷的关系。方法回顾性总结1998年6月～2003年2月采用2枚中空双螺旋加压螺纹钉治疗股骨颈骨折52例患者骨折复位情况,对患者年龄、性别、骨折部位及类型、受伤至手术时间与股骨头缺血坏死和晚期塌陷之间的相关关系进行分析。结果术后随访5～55个月,平均30个月。本组47例骨折愈合,愈合率90.4%。5例骨折不愈合,出现股骨头缺血坏死,占9.6%,改行人工股骨头置换术或人工全髋关节置换术。骨折愈合时间3～8个月,平均5个月。结论对预后影响最大因素是骨折的部位及类型,其次是骨折的复位与固定情况和患者年龄。新鲜股骨颈骨折的治疗原则应力求早期、解剖复位、牢固固定。2枚中空双螺旋加压螺纹钉内固定治疗股骨颈骨折疗效可靠,可莸得良好的固定效果,有动力加压作用,创伤小,骨折愈合率高,并发症少。

Analytic Study on Internal Fixation with Lag Double Thread Screw in Femoral Neck Fracture

Objective To review the healing patterns of femoral neck fracture treated by lag double thread screw. Methods Fifty-two patients with femoral neck fractures admitted during June 1998 to February 2003,were treated by internal fixation with two lag double thread screws. The reduction patterns,age,sex,location and type of fracture,time from injury to operation and the correlation of ischemia necrosis and late collapse of femoral neck were analyzed. Results All of the patients were followed up from 5 months to 55 months(average 30 months).Of these patients, there were 47 union(97 %),5 nonunion and necrosis of femoral head(9.6 %) reoperated by artificial femoral head replacement or artificial total hip joint replacement. The union time of fracture was 3 to 8 months(average 5 months). Conclusion The location and type of fracture are the main factors influencing the prognosis of femoral neck fracture, other influencing factors are reduction, fixation of fracture and age patient. The therapeutic principles for fresh fracture of femoral neck is anatomical reduction and firm fixation and treating as early as possible. The internal fixation with two lag double thread screw is a reliable approach in femoral neck fracture, with the advantages of high reduction rate dynamic pressing less trauma and complication.