微创空心加压螺钉内固定治疗股骨颈骨折

目的 探讨应用微创空心加压螺钉内固定治疗老年股骨颈骨折的临床疗效.方法 自2000年4月～2004年4月对128例经微创空心螺钉内固定治疗老年股骨颈骨折的临床资料进行回顾性分析.结果 GardenⅠ型骨折17例,Ⅱ型86例,Ⅲ型25例.损伤至手术时间1～2W,手术时间平均60min,均未出现伤口感染,下肢深静脉血栓,肺栓塞或内固定物断裂现象,无死亡发生.均得到随访,时间16～48个月,平均30月.所有病例骨折愈合良好,5例（5/128,3.9%）术后股骨颈短缩移位,6例（6/128,4.6%）出现不同程度的股骨头坏死.术后Harris髋关节功能评分平均95.4分.结论 微创空心加压螺钉内固定治疗股骨颈骨折具有创伤小、方法简便、固定牢靠、可早期功能锻炼、并发症少的优点,是治疗GardenⅡ、Ⅲ型老年性股骨颈新鲜骨折的理想方法.

Minimally invasive internal fixation by cannulated compression screws for femoral neck frectures

Objective To investigate the clinical results of minimally invasive internal fixation by cannulated compression screws in the treatment of femoral neck fractures. Methods The autbors retrospectively analysed clinical data of 128 patients with femoral neck fractures treadment of femoral neck fractures from 4.2000 ~ 4.2004. Results According to the Garden classification ,the patients comprised 17 cases of type 1,86 cases of type II, 25 cases of type III.The mean time from injury to surgery was 1 ~ 2 weeks,the mean operation time was 60 min. No wound infection,deep venous thrombosis of leg,pulmonary embolism or breakage of internal fixation occurred. No patients died.Follow-up observation ranged 16 ~ 48 months,with a mean of 30 months.Nomal bone union was obtained in all the cases.Postoperatively,shortening of femoral neck took place in 5 patients (5/128,3.9%) and different degrees of osteonecrosis happened in 6 patients (6/128,4.6%). The mean postoprative Harris hip score was 95.4. Conclusions Application of minimally invasive method and cannulated compression screws fixation is an effective means to tread senile fresh femoral neck fracture (Garden I and II Xfor it leads to early ambulance, short time of hospitalization or bed rest,minimal invation,stable fixation,Iess complications and simplicity.