青壮年股骨颈骨折关节囊切开减压与非切开复位疗效的比较研究

Comparative study of therapeutic efficay of joint capsule decompression and non-open reduction in femoral neck fracture

目的:评价关节囊切开减压与非切开治疗青壮年股骨颈骨折的疗效。方法:回顾性分析62例股骨颈骨折行骨折复位空心钉内固定术,前侧关节囊切开减压组36例,非切开组26例。选择骨折愈合率,股骨头无菌性坏死率和Harris评分,评价两种方法的手术效果。结果:随访14～42个月。前侧关节囊切开组:2例骨折不愈合合并股骨头无菌性坏死,骨折愈合率94.4%,股骨头坏死率5.6%,Harris评分优良率91.7%。非切开组:4例骨折不愈合合并股骨头无菌性坏死,骨折愈合率84.6%,股骨头坏死率15.4%,Harris评分优良率76.9%。两组比较差异有统计学意义(P<0.05)。结论:关节囊切开减压能提高骨折愈合率,降低股骨头无菌性坏死的发生率。

Objective：To investigate the therapeutic effect of joint capsule decompression and non-incision treatment of femoral neck fractures in young adults.Methods：62 cases of femoral neck fracture with cannulated screw fixation were analyzed retrospectively.36cases of anterior joint capsule decompression and 26 cases of non-open reduction were compared in aspects of fracture healing,aseptic necrosis of femoral head and Harris score.Results：After follow-up of 14~42 months,in the anterior joint capsule incision group,there were 2 cases of nonunion of the femoral head with aseptic necrosis,healing rate was 94.4%,femoral head necrosis rate was 5.6%,and Harris score good rate was 91.7%.In the control group,4 cases of nonunion of the femoral head with aseptic necrosis,fracture healing rate was 84.6%,femoral head necrosis rate 15.4%,and Harris score good rate was76.9%.The difference between the two groups was statistically significant（P0.05）.Conclusion：The joint capsule decompression can increase healing rate,reduce the incidence of aseptic necrosis of the femoral head.