股骨干合并同侧股骨颈骨折21例临床诊治分析

目的探讨股骨干合并同侧股骨颈骨折的临床特点和治疗效果。方法选择本院2006年3月至2009年3月股骨干合并同侧股骨颈骨折的患者21例,分析其骨折分类和合并伤情况。在本组病例中,根据患者伤情,先处理危及生命的合并伤,再处理骨折。对于股骨干骨折的治疗采用切开复位加压钢板内固定术,对于股骨颈骨折的处理均采用空心加压螺纹钉固定术,术后进行随访。结果本组病例随访时间平均16个月,所有患者骨折均愈合。术后无严重并发症发生,无1例发生股骨头缺血性坏死。15例股骨干骨折患者在术后7个月内均获得愈合,其余6例股骨颈骨折患者在术后8个月获得愈合;21例股骨颈骨折患者在术后6个月内均获得愈合。结论对于同侧股骨干合并股骨颈骨折来说,稳定的股骨颈骨折容易在诊治中漏诊或者延诊,故股骨干骨折时要考虑股骨颈是否骨折;在治疗时,股骨干骨折可采用加压钢板内固定术,股骨颈骨折可采用空心加压螺钉固定术。

Objective To explore the clinical character and efficacy of ispilateral fracture of femoral neck and shaft. Methods 21cases with ispilateral of femoral neck and shaft were selected from march,2006 to march,2009,the type of fracture and associated injury were analyzed. In all the cases, according to the injury state, the associated injury which could threaten the life firstly was done with, then the fracture was treated. Open reduction and compression plate fixation was used to the patients with fracture of formal shaft, and percutaneous cannulated compression screws fixation was used to the fracture of femoral neck. the follow-up was done for all the cases after treatment. Results The average time of follow-up was 16 months, the fracture of all the cases healed. No serious complications existed. No cases had avascular necrosis of femoral head, fracture of femoral shaftin 15 cases healed postoperative 7 months , and the other 5 cases healed postoperative 8 months;fracture of femoral neck in 21 cases healed postoperative 6 months. Conclusions For the ispilateral fracture of femoral neck and shaft, the stable fracture of femoral neck is easily misdiagnosised and delayed diagnosis, so fracture of femoral neck should be considered when femoral shaft has fracture ; when treat the ispilateral fracture of femoral neck and shaft, open reduction and compression plate fixation may be used to the fracture of femoral shaft, percutaneous cannulated compression screws fixation may be used to the fracture of femoral neck.