长收肌和闭孔神经切断治疗内收型股骨颈骨折

CLINICAL STUDY ON TREATMENT OF ADDUCTIVE FEMORAL NECK FRACTURE BY AMPUTATION OF LONG ADDUCTOR MUSCLE AND OBTURATOR NERVE

采用长收肌和闭孔神经切断、经皮折断式加压螺纹钉固定术治疗内收型股骨颈骨折 35例 ,并与采用常规经皮折断式加压螺纹钉固定术治疗的 17例进行疗效比较。经 12～ 48个月的随访 ,治疗组优良率为 85 .7% ,2例骨折不愈合 ,未出现股骨头坏死 ;对照组优良率为 6 4.7% ,2例骨折不愈合 ,1例发生股骨头坏死。治疗组疗效明显优于对照组 ( P<0 .0 5 ) ,尤其是颈干角的维持明显好于对照组 ( P<0 .0 5 )。表明长收肌、闭孔神经主干切断可增强内收型股骨颈骨折整复后的稳定 ,维持颈干角 ,减少髋内翻畸形的发生。

Thirty-five cases of adductive femoral neck fracture were treated by amputation of long adductor muscle and obturator nerve and fixation with percutaneous.The curative effect was compared with that treated only by fixation with routine percutaneous compressive screw.After 12～48 months'follow-up,in the control group the excellent-good rate was 64.7% withe 2 cases of monunion and 1 cae of femoral head necrosis,while in the treatment group,the excellent-good rate was 85.7% with 2 cases of nonunion and without femoral head necrosis,which was much higher than that in the control group( P <0.05),especially in maintenance of the collodiaphyseal angle( P <0.05).It indicatets that amputation of long adductor muscle and oburator nerve can strengthen postreductive stability of adductive femoral neck fracture,maintain the co;;odiaphyseal angle and decrease the incidence of coxa varus.