经皮螺纹钉治疗新鲜股骨颈骨折预后的影响因素探讨

Study of Disadvantageous Prognosis Factors in Fresh Femoral Neck Fractures Treated by Thread Pins.

探讨影响经皮螺纹钉治疗新鲜股骨颈骨折预后的因素。方法：对１９８１年以来采用此法治疗１５６例中的１２２例进行平均４．６年的随访。结果：优良率为８０．３％（９８／１２２），骨不连８例（占６．６％），缺血性坏死１０例（占８．２％），以头下型、ＧａｒｄｅｎⅣ型以及粉碎骨折合并严重骨质疏松者多见，与术前、术中及术后的医源性因素有密切关系。结论：（１）影响预后的因素是适应证选择不当，手术失误以及术后处理不当。（２）移位明显的头下型骨折和股骨颈粉碎骨折采用此术式应慎重，若同时伴有严重骨质疏松症则不宜采用此术式。

Objective:To study the disadvantageous prognosis factors in fresh femoral neck fractures treated by thread pins.Methods:156 cases of fresh femoral neck fracture had been treated by thread pins.122 cases among them had been followed up for 4 6 years on an average.Results:The excellent and good were seen in 80 3%,non union,avascular necrosis of femoral head occurred in 6 6% and 8 2% respectively.These were often observed in subcapital,Garden IV,comminuted fractures with osteoporosis and also closely related to the pre operative,operative and post operative incorrect iatrogenic factors.Conclusion:Improper cases selection,incorrect operative performance and wrong post operative management would have bad effect on their prognosts.Subcapital and comminuted fractures of femoral neck with displacement,especially with osteoporosis,were unsuitable for this kind of operation.