空心加压螺纹钉治疗新鲜股骨颈骨折的临床疗效分析

The clinical effect and analysis of cannulated screw treatment of fresh femoral neck fracture

目的探讨空心加压螺纹钉治疗股骨颈骨折的临床疗效。方法本院自2004年1月至-2008年12月,采用手术治疗股骨颈骨折112例患者。根据Garden分型,Ⅱ型14例,Ⅲ型44例,IV型54例。采用X线透视下闭合复位或开放复位空心加压螺纹钉固定。结果所有患者均获得随访。随访12-36个月,平均26个月。除4例骨折不愈合,股骨头坏死,二次手术行髋关节置换,其余全部骨性愈合,平均愈合时间3-7个月,平均4.2个月。功能按Harris评分标准：优76例,良24例,可8例,差4例,后均行全髋关节人工假体置换术,优良率89.3%。结论空心加压螺纹钉基本解决了股骨颈骨折的愈合。是治疗股骨颈骨折较理想的治疗方法。骨折早期手术,满意复位,良好固定及早期功能锻炼,有利于减少并发症,促进骨折愈合,提高临床治愈率。

Objective To explore the clinical efficacy of hollow compression screw for femoral neck fractures.Methods 112 cases of surgical treatment in patients were selected from January 2004 to December 2008 with femoral neck fracture.According to Garden classification,Ⅱ-type 14 cases,Ⅲ-type 44 cases,IV type 54 cases.X-ray fluoroscopy was applied during reduction or open reduction with cannulated screw fixation.Results All patients were followed up of 12 to 36 months,an average of 26 months.Except 4 cases of nonunion,femoral head necrosis,the second line of hip replacement surgery,and the rest of bone healing,with an average healing time of 3 to 7 months,an average of 4.2 months.Functional score according to Harris criteria： excellent in 76 cases,good in 24 cases,8 cases well and poor in 4 cases,the latter underwent total hip prosthesis replacement surgery,excellent rate of 89.3%.Conclusion The hollow compression screw basically solved the healing of femoral neck fracture.The treatment of femoral neck fracture ideal method of treatment.Early fracture surgery,satisfactory reduction,stable fixation and early functional exercise will help reduce complications and promote fracture healing,improve the clinical cure rate.