股骨干骨折合并同侧股骨颈骨折的外科治疗分析

Analysis of the surgical treatment on Femoral fracture merge ipsilateral with femoral neck fracture

目的探讨股骨干骨折合并同侧股骨颈骨折的临床特点、漏诊原因、临床疗效。方法 22例同侧股骨干合并股骨颈骨折患者中6例采用空心钉加AO钢板固定,5例采用动力髋螺钉(DHS)装置固定,11例采用股骨重建钉固定。结果股骨干骨折愈合时间为6个月-16个月,股骨颈骨折愈合时间为12个月-24个月;有3例股骨干中下段骨折钢板断裂延迟愈合;股骨颈骨折Ⅰ期愈合15例,股骨头缺血坏死7例,按Friedman评定标准优良15例,差7例(漏诊5例)。结论股骨干骨折患者应摄髋臼X线片,早期确诊,早期行手术治疗。

Objective To explore clinical characteristics, misdiagnos reasons, clinical curative effect of the femoral fracture with lateral femoral neck fracture. Methods 22 cases of ipsilateral femoral with lateral femoral neck fracture treatment, 6 patients with hollow nail and AO plate fixed, 5 eases of DHS device fixed, 11 cases of femoral reconstruction nail fixed. Results femoral fracture healing time 6-16 months, femoral neck fracture healing 12-24 months. 3 cases of femoral fractures of lower section steel plate fracture delayed healing; 15 cases femoral neck fracture primary healing , 7 patients ischemic necrosis of femoral head , according to Friedman evaluation criteria good in 15 cases, seven patients （misdiagnosis 5 cases ） .Conclusion femoral fracture with femoral neck fracture patients should be taken acetabulum X ray film, early diagnosis, early surgical treatment.