股骨干骨折合并同侧髋周围骨折脱位

目的　探讨同侧股骨干并髋周围骨折脱位的临床特点及诊断要点。方法　对 1998年 2月～ 2 0 0 2年 10月收住的股骨干骨折 181例 ,合并同侧髋周围骨折脱位 16例初诊、漏诊、延误诊断及确诊时间、治疗方法和随访结果等进行回顾。结果　 181例股骨干骨折中并同侧髋周围骨折脱位 16例 ,其中并髋关节脱位 2例 ,并股骨颈骨折 3例 ,并股骨头骨折 2例 ,并髋臼骨折 4例 ,并粗隆间骨折 3例 ,并粗隆下骨折 2例 ,16例中采用手术治疗 12例。非手术治疗 4例。平均随访 15 6个月 (6～ 2 8个月 )。除 1例股骨头坏死 ,1例髋内翻 ,其余骨折均获愈合。结论　对高能量损伤造成的股骨干骨折应常规摄骨盆正侧位X线片。股骨干骨折内固定术后仍诉髋周围疼痛的患者应反复检查 ,一但发现合并髋周围骨折脱位应争取早期复位内固定。手术治疗效果优于非手术治疗

Fracture of Femoral Shaft with Ipsilateral Peripheral Coxa Fractures and Dislocation

Objective To explore the clinical characteristics and key points of the diagnosis of ipsilateral femoral shaft and peripheral coxa fractures and dislocation.Methods This paper was based on a review of the time,treatment methods and follow up on the outcome of the initial diagnosis,missed diagnosis,delayed diagnosis and confirmed diagnosis of 181 cases of the fracture of femoral shaft and 16 cases of ipsilateral peripheral coxa fracture and dislocation,of the total number,there were 2 cases of concurrent coxa joint dislocation,3 cases of concurrent femoral neck fracture,2 cases of concurrent femoral head fractures, and 4 cases of concurrent acetabular fracture,3 cases of concurrent inter trochanteric fracture,and 2 cases of concurrent below trochanteric fracture.12 out of the 16 cases of were treated through operations and 4 cases were treated with non operative methods.Results Sixteen cases were followed with an average of 15 6 months(ranging from 6 to 28 months).With the exception of one case of femoral head necrosis and one case ofcoxa vara,the rest of the fractures healed.Conclusion Fracture of femoral shaft resulting from hgh energy injury should be treated by taking conventional anterioposterior and lateral X ray films.Patients who complained of peripheral coxa pains after receiving the internal fixation operation for the fracture of femoral shaft should be subjected to repeated examinations,to ensure that any concurrent peripheral coxa fracture and dislocation received timely restoring internal fixation.The efficacy of operative treatment is better than that of non operative treatment.