中青年股骨颈移位骨折25例临床治疗

Treatment of Displaced Fracture of the Femoral Neck in 25 Patients under 60 Years of Age

目的：观察应用切开复位内固定治疗60岁以下股骨颈骨折的手术疗效。方法：采用切开复位空心加压螺钉或股骨近端解剖锁定钢板内固定手术治疗60岁以下股骨颈骨折25例。按Garden分型,Ⅲ型19例,Ⅳ型6例。结果：25例患者术后随访6~30个月,23例患者骨折得到骨性愈合,2例出现股骨头缺血坏死,股骨头塌陷,行人工关节置换手术。按Harris评分优21例、良2例、可0例、差2例,优良率92%疗效满意。结论：切开复位内固定治疗60岁以下股骨颈移位骨折,能够提高骨折愈合几率,减少股骨颈坏死几率,对改善患者的生活质量有积极的意义。

Objective：To observe the curative effect of open reduction and internal fixation in the treatment of patients with femoral neck fracture less than 60 years old,and to summary the experience of the treatment course.Methods：All 25 cases of the femoral neck fracture,less than 60 years old,were treated by open reduction and then internal fixated with cannulated cancellous screws or proximal femoral anatomic locking compress plate.According to Garden classification,there were 19 cases of type Ⅲ and 6 cases of type Ⅳ.Results：All patients were followed up for 6-30 months.There were 23 cases of fracture healing and 2 cases of ischemic necrosis of the femoral head and then collapsed,which were treated with artificial joint replacement.The clinical outcomes were evaluated in accordance with Harris hip score,excellent with 21 cases,good with 2 cases,no fair case,and poor with 2 cases.The excellent and good rate was 92%.Conclusion：The open reduction and internal fixation is reliable for treating displaced fracture of the femoral neck less than 60 years old.The treatment can improve the chance of fracture healing,and reduce the risk of ischemic necrosis of the femoral head.So it is positive significance to improve the quality of life.