髋关节后脱位合并股骨头骨折的外科治疗

Operative treatment of posterior dislocation of hip with femoral head fracture

目的:探讨各种不同类型髋关节后脱位合并股骨头骨折的外科治疗效果。方法:自1995年5月～2004年1月,共收治29例该类病例,根据Pipkin分4型:Ⅰ型11例,Ⅱ型10例,Ⅲ型4例,Ⅳ型4例。结果:本组共23例获得随访,随访时间6个月～9年,随访内容包括:临床及影像学检查。根据美国矫形外科学院评定标准,结果:优10例,良8例,可3例,差2例。优良率为78.3％。结论:早期切开复位,可吸收钉固定股骨头骨折是治疗髋关节后脱位合并股骨头骨折理想方法。

Objective: To discuss clinical value of operative treatment of posterior dislocations of hip with femoral heads fracture. Method:Between May 1995 and January 2004,29 patients with posterior dislocations of hip with femoral heads fracture were treated,11 were type Ⅰ ,10 type Ⅱ ,4 type Ⅲ,4 type Ⅳ according to Pipkin' s criteria. Result:Twenty-three patients were followed-up for 1/2-9 years, the physical examinations and radiologic controls of the patients who were called for last follow-up examination were performed, the results were excellenct 10 cases, good 8 cases,fair 3 cases,poor 2 cases according to system of assessment suggested by American academy of orthopedic surgeons. Rate of excellent and good result was 78.3%. Conclusion :The key to excellent and good result achieved in posterior dislocations of hip with femoral heads fracture is decided to early open reduction and internal fixation of femoral heads fracture with adsorbent screw.