选择性血管造影评价股骨颈骨折后股骨头血供变化

Digital subtraction angiography evaluation of blood supply of the femoral head after femoral neck fracture

目的：应用选择性血管造影技术（DSA）探讨不同类型股骨颈骨折后股骨头血供情况及手术对血供的影响。方法对28例股骨颈骨折患者闭合复位螺钉内固定手术前后行患、健侧髋部DSA，统计显影的支持带动脉数目。结果 Garden Ⅰ～Ⅳ型骨折术前支持带动脉数之间患/健比差异有统计学意义，均值呈递减趋势（P＜0.05）；同型骨折手术前后比较，Carden Ⅰ～Ⅲ型差异均无统计学意义（P＞0.05），Carden Ⅳ型差异有统计学意义（P＜0.05）。结论 DSA可以较准确地评价不同类型股骨颈骨折后股骨头血供，有利于指导临床治疗方案的选择。

Objective To investigate the blood supply of femoral head after different types of femoral neck fractures and the affection result in it caused by the compression screw fixation through using digital subtraction angiography （DSA）.Methods 28 patients with femoral neck fracture who planed to receive the treatments of closed reduction and compression screw fixation were enrolled.For the sake of collecting statistics of the retinacular artery′s number, DSA was used to the circumflex femoral artery and retinacular artery of the preoperative and postoperative patients′hips on the sicked and the healthy side separately.Results The ratios on the average of the sick and the health had were different and they were reduced gradually in the GardenⅠ~Ⅳfractures （P〈0.05 ）.Compared with the aver-age ratios on the sick and the health of the preoperative and postoperative in the same type of fracture,the GardenⅠ~Ⅲ differences all had no statistical difference （P〉0.05 ）while the differences of GardenⅣhad statistical sig-nificance（P〈0.05）.Conclusions DSA can accurately evaluate the blood supply of different types of femoral neck fracture,and help to guide the choice of clinical treatment .