闭合复位经皮空心加压螺纹钉治疗老年股骨颈骨折的预后及并发症

A retrospective study of close reduction plus percutaneous cannulated screw fixation for femoral neck fractures in elderly patients

目的 探讨老年股骨颈骨折患者闭合复位经皮空心螺钉术后的预后及并发症.方法 回颐性分析本院经空心加压螺纹钉治疗的老年股骨颈骨折145例,其中Garden Ⅰ型22例,Ⅱ型55例,Ⅲ型52例,Ⅳ型16例;术后2年随访患者术后并发症,股骨头坏死或骨折不愈合的情况以及患肢功能.结果 术后Garden Ⅰ～Ⅳ型发生骨折不愈合或者缺血性坏死的发生率分别为4.5％、3.6％、15.4％、31.3％.术后并发症的发生率在Garden分型的四型中差异无统计学意义.结论 闭合复位经皮空心螺钉术对于老年股骨颈骨折患者是一个有效的方法,特别在Garden Ⅰ型和GardenⅡ型的患者中应是首选治疗方法.

Objective To evaluate the results and complications of femoral neck fractures in elderly patients treated with close reduction plus percutaneous cannulated screw fixation. Methods We retrospetively Ively studied 145 patients older than 60 years who presented with femoral neck fractures that underwent cannulated screw fixation between 2003 and 2011. The results of 145 patients that had 2-year follow-up included postoperative complications and hip joint function which was evaluated according to the Harris score. Garden classification was use for the patients, 22 of whom were type I , 55 were type II , 52 were type III, 16 were type IV. Results The incidences of nonunion or avascular necrosis were 4.5% , 3.6% , 15.4% , and 31.3% in the patients who were classified as Garden I , Garden II , Garden III, and Garden IV respectively. There were no statistical differences in the rate of postepereativeive complications in the patients with Garden classification. The rate of postepercativeive complications in the patients with ASA III was higher than thsse in ASA I and ASA 11. Conclusions Close reduction plus percutaneous cannulated screw fixation is an effectiveive method for treating femoral neck fractures in the patients more than 60 tears old and is a prior method in the patients of Garden I and Garden II types.