空心加压螺钉结合股方肌骨瓣移植术治疗股骨颈囊内骨折

Treatment of intracapsular fracture of femoral neck by hollow compression screw combined with quadratus femoris bone flap graft

目的探讨空心加压螺钉结合股方肌骨瓣移植术治疗股骨颈囊内骨折的中期疗效。方法回顾性分析2007年1月～2011年1月应用空心加压螺钉结合股方肌骨瓣移植术治疗股骨颈囊内骨折48例的临床资料,得到随访21例。结果48例患者手术时间106～123(113±10)min;出血量250～400(300±15)ml;住院7～13(10±2)d。21例患者随访1～5年,平均3.1年。股骨头坏死1例,发生率4.8%;余20例中,3例髋关节屈曲,外展轻度受限,其他关节功能正常。股骨颈骨折均骨性愈合,优19例,良1例,差1例,优良率95.2%。结论本术式操作简单,对患者损伤小,固定可靠,骨折不愈合及股骨头坏死率低,髋关节功能恢复好,是治疗青壮年股骨颈囊内骨折的较好方法。

Objective To analyze the metaphase curative effects of hollow compression screw combined with quadratus femoris bone flap transplantation on intracapsular fracture of the femoral neck. Methods A retrospective analysis was made in the clinical data of 48 patients with intracapsular fracture of the femoral neck treated by hollow compression screw combined with quadratus femoris bone flap transplantation from January 2007 to January 2011. The follow-up was made in 21 cases. Results The operative time of the 48 cases ranged from 106 to 123 min with the average of（ 113 ± 10） min. The bleeding volume ranged from 250 to 400 ml with the average of（300 ± 15 ） ml. The days of hospitalization ranged from 7 to 13 d with the average of（ 10 ± 2） d. The 21 cases were followed up for 1 to 5 years with the average time of 3.1 years. The necrosis of femoral head occurred in one case, and the incidence was 4.8%. Among the other 20 ones,the bucking of hip joint occurred in 3 ones with the mild limitation of abduction, and other joint functions were normal. All femoral neck fractures got bone union. The curative results were excellent in 19 cases, good in one, and poor in one, and the excellence and good rate was 95.2%. Conclusion The operation is simple with small damage to the patients. The fixation is reliable. The rates of disunion and osteonecrosis is low, and there is a good recovery of hip joint function. It is a good treatment method for the intracansular fracture of the femoral neck in vounadults.