两种方法治疗青壮年股骨颈骨折的疗效比较

Clinical Efficacy Comparison of Two Methods for the Treatment of Femoral Neck Fracture in Youth and Middle-aged Patients

【目的】比较分析空心钉内固定加带旋髂深血管蒂髂骨瓣移植术与单纯的空心钉内固定术治疗青壮年股骨颈骨折的疗效。【方法】回顾总结采用两种方法治疗的青壮年股骨颈骨折患者73例的临床资料。其中采用带旋髂深血管蒂髂骨瓣移植术治疗40例（治疗组），采用单纯的空心钉内固定术治疗33例（对照组）；分别比较两组的疗效、股骨头坏死发生率、平均愈合时间。【结果】术后平均随访50（33～103）个月，治疗组术后3～6个月均达骨性愈合，平均愈合时间4．2个月，髋关节功能优良率达90％，无股骨头缺血坏死病例；对照组32例术后4～12个月达骨性愈合，平均愈合时间6．3个月，1例不愈合，髋关节功能优良率72．7％，4例出现股骨头缺血坏死。治疗组的疗效、股骨头坏死发生率、平均愈合时间均优于对照组。【结论】空心钉内固定加带旋髂深血管蒂髂骨瓣移植术曼适合用于治疗青壮阜股骨颈骨折．

[Objective]To compare the effects of treatment for femoral neck fracture in youth by transplantation of pedicular bone flap with deep iliac circumflex artery and by simple hollow screws internal fixation. [Methods]Seventy three cases of femoral neck fracture in youth were treated with the above two methods. All the cases were divided into treated group（40 cases） and control group（33 cases） ： the former was treated by transplantation of pedicular bone flap with deep iliac circumflex artery and hollow screws internal fixation; the latter were treated by simple hollow screws internal fixation alone. The effect, incidence of femur head necrosis and mean time of healing were compared. [Results]After an average 50 （33-103） months follow-up, all the cases of treated group were healed in a mean time of 4.2 months, excellent rate of hip joint function was 90%, no femur head necrosis occurred; 32 cases of control group were healed in a mean time of 6.3 months, 1 case nonunion, excellent rate of hip joint function was 72.7%, 4 femur head necroses occurred. The treated group was better than control group in these aspects. [Conclusion]Transplantation of pedicular bone flap with deep iliac circumflex artery and hollow screws internal fixation is a better method to treat femoral neck fracture in youth and middle-aged patients.