未成年人外伤性股骨颈Delbet Ⅰ,Ⅱ,Ⅲ型骨折综合治疗分析

Analysis of comprehensive treatment of pediatric traumatic femoral neck Delbet Ⅰ,Ⅱ,Ⅲ fracture

目的分析未成年人外伤性股骨颈骨折采用空心钉内固定配合中医药治疗的效果及并发症的发生率。方法 2004—2006年佛山中医院小儿骨科共收治28例外伤性股骨颈骨折(DelbetⅠ,Ⅱ,Ⅲ型),新鲜骨折23例采用闭合复位空心钉内固定,陈旧骨折5例采用切开复位空心钉内固定,术后石膏外固定8周,配合我院中药制剂生骨片、骨宝口服液口服,舒筋洗药外用熏洗患处,配合功能锻炼。术后10月拆除内固定。结果全部病例获得随访(5.8±0.6)年,平均骨折愈合时间(5.0±1.5)月。优良率85.7%,股骨头缺血坏死率7.1%。2例术后1年内出现股骨头缺血性坏死,1例出现髋内翻并退行性关节炎,1例出现髋内翻短髋畸形。结论未成年人外伤性股骨颈骨折早期坚强牢固内固定固定骨折端,同时配合中医药治疗,可以获得良好的疗效,可降低股骨头坏死等并发症的发生率。

Objective To analyze the effect of internal fixation of hollow screw combined with traditional Chinese medicine in the treatment of traumatic fracture of femur neck and the incidence of complication. Methods From 2004 to 2006, 28 cases of traumatic femoral neck fracture （ Delbet I , Ⅱ , Ⅲ ） hospitalized in Foshan City TCM Hospital, 23 cases of fresh fracture treated with closed reduction and cannulated screw fixation ; 5 cases of old fracture treated with open reduction and internal fixation, externally fixed with postoperative plaster for 8 weeks, combined with the traditional Chinese medicine preparation for Bone tablet, Gubao oral liquid, Shujinxiyao, and functional exercise. 10 months after the operation, internal fixation was removed. Results All cases were followed up for （5.8±0.6） years, the average fracture healing time was （ 5.0 ± 1.5） months. The excellent rate was 85.7% , and the rate of avascular necrosis of the femoral head was 7.1%. 2 patients suffered ischemic necrosis of femoral head with 1 year. 1 case suffered coxa vara and degenerative arthritis, 1 case suffered coxa vara and short deformity of hip. Conclusion Early solid internal fixation of pediatric traumatic femoral neck fracture, combined with traditional Chinese medicine, can obtain good effect, reduce the incidence of complications, such as avascular necrosis of the femoral head.