切开复位DHS联合抗旋螺钉固定治疗青壮年股骨颈PauwelsⅢ型骨折

Open Reduction and Internal Fixation with DHS Combined with Anti-rotation Screw to Treat Pauwels Type Ⅲ Femoral Neck Fracture in Young Adults

目的:评价切开复位DHS联合抗旋螺钉固定治疗青壮年股骨颈PauwelsⅢ型骨折的临床效果。方法:采用回顾性分析的方法,总结2005年2月～2009年4月,我院手术治疗PauwelsⅢ型骨折患者26例。其中,男22例,女4例,年龄19～47岁,平均38.4岁。骨折按Pauwels型均为Ⅲ型,采用切开复位DHS联合空心钉固定。结果:本组患者随访时间20～70个月,平均31.2个月。除3例发生股骨头缺血性坏死外,其余23名患者骨折均得到愈合。根据Harris髋关节功能评分系统评估疗效,优18例,良5例,差3例。结论:切开复位DHS联合抗旋螺钉固定治疗青壮年股骨颈PauwelsⅢ型骨折的疗效肯定,解剖复位、坚强固定是获得满意疗效的关键。

Objective：To evaluate the result of Pauwels type Ⅲ femoral neck fracture in young adults treated with open reduction and internal fixation with DHS combined with anti-rotation screw.Methods＇A retrospective analysis was done on the clinical date of 16 cases of young Pauwels type Ⅲ tincture,which were surgically treated in our hospital from February 2005 to April 2009.There were 15 males and 1 females,with an average of 38.4 years old（ranged from 19 to 47 years old）.An were Pauwels type Ⅲ fracture and treated with the method of open reduction and fixed with DHS combined with anti-ration screw.Results：The average period of follow-up of these 16 cases was 20-70 months. 14 patients got fracture union,and 2 cases suffered from osteonecrosis of femoral neck.According to Harris criterion,the results of the treatment was evaluated as excellent in 11 cases,good in 3 cases,bad in 2 cases.Conclusion：Effect of the open reduction and internal fixation with DHS combine with anti-rotation screw to treat young Pauwels type Ⅲ fracture is definite,anatomic reduction and rigid fixation of operation can lower the rate of complications effectively.