股骨头骨折合并髋关节脱位19例回顾性分析

Approach to the treatment for dislocation of hip joint combined with fracture of the femoral head

目的 探讨股骨头骨折合并髋关节脱位的治疗方法及效果.方法 对2000年1月至2005年12月我科收治的19例股骨头骨折合并髋关节脱位患者的临床资料进行回顾性分析.按Pipkin分型, Ⅰ型4例, Ⅱ型8例, Ⅲ型3例,Ⅳ型4例.闭合复位后保守治疗1例,切开复位可吸收螺钉固定15例,人工股骨头置换2例,全髋置换1例.结果 15例可吸收螺钉固定患者均获得随访,随访时间为1～7年,平均3年6个月.优8例,良5例,可2例,差0例,优良率为86.7%.结论 早期诊断,术前对骨折分型,选择合适的手术切口及固定,以及适当扩大切开复位指征,对股骨头骨折合并髋关节脱位患者术后的功能恢复极为重要.

Aim To approach the results of surgical treatment of dislocation of hip joint combined with fracture of the femoral head.Methods 19 patients were treated surgically for dislocation of hip joint combined with fracture of the femoral head from January 2000 to December 2005.According to Pipkin＇s classification,there were type Ⅰin 4 cases,type Ⅱin 8,type Ⅲ in 3,type Ⅳ in 4.Closed reduction,open reduction and fixation with absorbable screw,artificial thigh bone replacement or total hip replacement were performed respectively.Results 15 cases with open reduction and fixation with absorbable screw were followed up from 1 years to 7 years,average 3 years and 6 months.In all the 15 cases,8 were excellent,5 good,2 fair but 0 failed,with an excellence rate of 86.7%.Conclusion The key to better result from treating dislocation of hip joint combined with fracture of the femoral head is early diagnosis and proper treatment.