DHS结合空心螺钉植骨内固定治疗青壮年股骨颈骨折

Internal Fixation of Dynamic Hip Screw and Hollow Screw Combined with Bone Craft for Femoral Neck Fracture in Young Adults

目的探讨DHS结合空心钉有限切开植骨内固定治疗青壮年股骨颈骨折的临床疗效及意义。方法回顾性分析我院2007年7月～2010年9月收治的29例青壮年股骨颈骨折患者的临床资料，均采用DHS结合空心钉行有限切开植骨内固定。结果本组29例患者均获随访，平均时间32．5（24～65）个月。无螺钉松动、退钉或断裂发生，1例发生延迟愈合，2例发生股骨头缺血性坏死，其余26例患者骨折均愈合，无肢体短缩、髋内翻畸形等其他并发症，骨折愈合时间平均4．5（3～17）个月。按Harris髋关节功能评分标准评定疗效，优22例（75．9％），良5例（17．2％），差2例（6．9％），优良率为93．1％。结论牵引床闭合复位DHS结合空心钉有限切开植骨内固定治疗青壮年股骨颈骨折，疗效肯定，解剖复位、坚强固定是获得满意疗效的关键，且可减少并发症的发生。

Objective To discuss the curative effects of the internal fixation of dynamic hip screw （DHS） and hollow screw combined with bone graft in the treatment of femoral neck fracture in young adults. Methods All 29 young adult patients with femoral neck fracture treated in our hospital from July 2007 to September 2010 were analyzed retrospectively. All cases were treated by internal fixation with DHS and hollow screw combined with bone graft. Results All 29 cases were followed up for 24 to 65 months with an aver- age of 32.5 months. No loosening, regress and breaking of the internal fixators were occurred. Except 1 case of delayed union and 2 cases of avascular necrosis of femoral head, the other 26 cases were achieved fracture healing without other complications as limb shortening or coax vara during 3 to 17 months after the operation. According to Harris hip function scoring system, the outcome was revealed excellence in 22 cases, good in 5 cases, poor in 2 cases, and the fineness rate was 93.1%. Conclusions The internal fixation of DHS and hollow screw combined with bone craft can achieved affirmative effects, and is an ideal choice for young adults with femoral neck fracture. The anatomical reduction and firm fixation are the key points to ensure the suc- cessful results and reduce the complications.