空心加压螺钉联合股方肌蒂骨瓣移植治疗不同类型股骨颈骨折疗效分析

目的 探讨用不同手术方法治疗不同类型的股骨颈骨折.方法 对基底型及经颈型股骨颈骨折采用手法复位2枚加压空心钉内固定(14例),对头下型及头颈型股骨颈骨折采用2枚加压空心钉内固定加殷方肌蒂骨瓣移植术(32例)治疗,并对疗效平均随访3年10个月.结果 股骨颈骨折愈合率为97.5%,股骨头坏死率2.4%,优良率92.6%.结论 闭合复位,加压空心钉内固定治疗经颈型及基底型股骨颈骨折;开放复位,2枚加压空心钉内固定加股方肌蒂骨瓣移植治疗股骨颈骨折头下型及头颈型,其操作简单,手术损伤小,出血少,骨折端愈合率高,股骨头坏死率低,是治疗不同类型股骨颈骨折的较为理想的方法.

Effect of cannulated compression screw treatment combined with muscular quadratus femoris-bone flap transplant in different femoral neck fractures

Objective To evaluate and compare the results of different operative methods for different types of femoral neck fracture. Methods To assess the treatment effect of two methods. Some eases of femoral neck fracture of basal-neck type and via-neck type were treated with closed reduction internal fixation with two compression spiral screws(14 eases). Other eases(32 eases) of femoral neck fracture of sub-head type and head-neck type were treated with closed reduction internal fixation with two cannulated compression screws and bone graft flaped with quadrate muscle of thigh. Results 41 cases were followed up. The average healing time was 3 years and 10 months.The bone healing rate was 97.5% ,femoral head necrosis occurred in 2.4% ,excellent and good rate was 92.6%.Conclusion Cases of femoral neck fracture of sub-head type and head-neck type were treated with closed reduction internal fixation with two cannulated compression screws and bone graft flaped with quadrate muscle of thigh. This method has the advantage of reliable fixation, simple operation, less injury and little hemorrhage. It can improve the rate of fracture union and reduce the rate of avascular necrosis of femoral head. It is the optimal method for the treatment of femoral neck fractures.