经皮空心螺纹钉内固定治疗股骨颈骨折

Evaluation of Percutaneous Internal Fixation with Hollow Screw in the Treatment of Femoral Neck Fracture

目的探讨经皮空心螺纹钉内固定治疗股骨颈骨折的临床疗效。方法2001年6月-2004年6月对48例股骨颈骨折[无移位骨折（GardenⅠ、Ⅱ型）22例，移位骨折（GardenⅢ、Ⅳ型）26例]采用闭合复位，经皮3枚空心螺纹钉呈倒三角进行内固定。结果术中出血量〈10ml；手术时间18—54min，平均32．5min。48例随访24—61个月，平均38．2月，97．9％（47／48）骨折愈合，愈合时间4—12个月，平均6．2月；髋关节功能Harris评分，优32例，良11例，可3例，差2例，优良率89．6％（43／48）。22例无移位骨折中，无骨折不愈合及股骨头缺血坏死；26例移位骨折中，骨折不愈合及股骨头缺血坏死分别为3．8％（1／26）和11．5％（3／26）。结论经皮空心螺纹钉内固定治疗股骨颈骨折疗效理想，具有操作简单、固定牢靠、并发症少等优点。

Objective To evaluate the efficacy of percutaneous internal fixation with hollow screw for femoral neck fractures. Methods From June 2001 to June 2004, 48 cases of femoral neck fractures, including 22 cases of fracture without displacement （type Garden Ⅰ and Ⅱ） and 26 cases of fracture displacement （ type Garden Ⅲ and Ⅳ） , were treated by close reduction and percutaneous internal fixation with 3 hollow screws forming inverse triangle. Results The intraoperative blood loss was less than 10 ml, and the average operation time was 32.5 min（ range, 18 -54 min）. 48 cases were followed up for 24 -61 months（ mean, 38.2 months） , union of fracture found in 97.9% （47/48） of cases, union time being 4 - 12 months（ mean, 6.2 months）. According to Harris score of hip joint function, 32 cases were excellent, 11 cases good, 3 cases fair, 2 cases bad, the rate of excellent and good results being 89.6% （43/48）. In 22 cases of fracture without displacement, there was no nonunion and isehemie necrosis of head of femur. In 26 cases of ,fracture displacement, the rate of nonunion and isehemie necrosis of head of femur were 3.8% （1/26） and 11.5% （3/26） respectively. Conclusions Pereutaneous internal fixation with hollow screw has the advantages of ideal curative effects, simple procedure, reliable fixation and less complications.