经皮空心螺钉持续减压治疗新鲜股骨颈骨折

Treatment of fresh fracture of femoral neck with continuous decompression through percutaneous hollow screw

目的采用经皮空心螺钉早期缓解股骨颈骨折所造成的骨内高压，并观察其对骨不连和股骨头缺血坏死的预防作用。方法新鲜股骨颈骨折行空心螺钉内固定后，经钉孔持续负压吸引４８～７２ｈ，予以髓内充分减压。结果治疗和随访４３例患者，３９例骨折愈合良好，优良率９０．７％；３例骨不连；１例股骨头坏死（２．３％），股骨头坏死率较低。结论早期充分减压可大大降低股骨颈骨折后股骨头缺血坏死率。

Objective To decrease the intraosseous high pressure caused by femoral neck fractures during the early period through perculaneous hollow screw, and observe its effect in preventing non union of fracture and necrosis of the femoral head. Method After internal fixation of femoral neck fractures with percutaneous hollow screws, continuous drainage was performed to decompress the intraosseous high pressure through the holes in the hollow screws for 48 to 72 hours. Results 43 cases received the remedy and they were followed up for 2 to 6 years, in which 39 cases healed up well. 3 cases developed into non union bone and 1 case into femoral head necrosis (2 3%) The excellent and good rate accounted for 90 7%. Lower rate of osteonecrosis of the femoral head was proved to have the statistical significance ( P <0 05 ). Conclusion Early and full decompression might lower the incidence of femoral head necrosis and it might be helpful for the healing of the femoral neck fracture.