股骨颈骨折的外科治疗及实验研究

Surgical Treatment and Experimental Studies ofFemoral Neck Fracture

经临床及实验研究，作者认为传统三刃钉内固定术冶疗股骨颈骨折愈合率低的主要原因在于插钉本身不能有效的消除骨折后产生的剪切应力；骨折端的真正嵌插性复位是将剪切应力转变为压缩应力，是保证骨折愈合的关键因素。因此作者设计了股骨颈“Ｕ”形截骨、头颈嵌插术治疗移位型股骨颈骨折６５例。经２年以上随访，骨折全部愈合，其中２例股骨头轻度坏死，晚期呈扁平髋。所有病例都行走自如，功能恢复满意，无其他并发症。

AbstractAccording to the results of clinical and experimen-tal studies, the authors concluded that, the cause ofnon-union following classical nailing of femoral neckfractures was the failure to eliminate the shearingstress effectively and that impaction reduction of thefragments can turn the shearing stress to compression,enhancing fracture union. The author therefore de-signed a new technique of″U″shaped osteotomy overthe femoral neck resulting in impaction of femoral headwith the neck. The procedure was carried out in 8 5cases of fractures of the femoral neck. The age of thepatients rangedfrom 27 to 80 years.Follow-up of 2 years revealed bone union in every case. Two had mildfemoral head necrosis andcoxa plana developed later.All had satisfactory functional recovery of the hips.