带血管腓骨移植与加压螺旋钉内固定治疗股骨颈骨折骨不连

Treating Femoral Neck Fracture Nonunion by Vascularized Fibula Graft Combined with Compression Screw Internal Fixation

目的 :总结加压螺旋钉内固定与带血管腓骨移植术治疗股骨颈骨折骨不连的效果。方法 :对 46例股骨颈骨折骨不连在直视下解剖复位后 ,以直径 9mm的加压螺旋钉固定 ,再将带有腓动静脉的腓骨跨过骨折线嵌入股骨头、颈部 ,螺丝钉固定 ,将腓动静脉与旋股外侧动静脉吻合 ,随访 1～ 8年。结果 45例获得骨性愈合 ,1例失败。股骨头缺血坏死 2例。结论 :加压螺旋钉内固定结合带血管腓骨移植可有效的治疗股骨颈骨折骨不连。

Objective: To summarize the effect of compression screw internal fixation combined with vascularized fibula graft for femoral neck fracture nonunion.Method:After anatomical replacement under direct vision on 46 cases of femoral neck fracture nonunion,The fracture was fixed by a 9mm diameter compression screw.With fibular artery and vein attached on,the fibular graft was inserted into the femoral head and neck.The fibular graft across the fracture line in femoral neck then pinned the fibula section with a 9 mm diameter compression screw.In the 1 8 years'follow-up,there were 45 cases obtaining bony healing,1 defeated,and 2 got ischemic necrosis at femoral head.Conclusion:It is effective to treat femoral neck fracture nonunion with the method of compression screw internal fixation combined with vasculaized fibula graft.