缝匠肌肌骨瓣在中青年股骨颈头下型骨折治疗中的应用

Clinical application of sartorius muscle pedicle bone graft to management of subcapital fractures of femoral neck in young adults

目的总结缝匠肌肌骨瓣移植治疗中青年股骨颈头下型骨折的临床疗效。方法回顾分析2006年6月—2012年7月收治的76例中青年股骨颈头下型骨折患者治疗效果。手术均采用缝匠肌肌骨瓣联合加压空心螺钉固定。按照Harris髋评分标准进行疗效评价。结果 76例均获随访,其中72例术后影像学表明均骨性愈合(72/76,94.7%),患者末次随访均按照改良Harris评分标准:优54例,良12例,差10例,优良率86.8%。结论本术式治疗中青年股骨颈头下型骨折能改善股骨头血供,促进骨折愈合,明显减低股骨头坏死及骨折不连,因此,是一种治疗中青年股骨颈头下型骨折有效的手术方法。

Objective To investigate the clinical outcomes of the sartorius muscle pedicle bone graft in the management of subcapital fractures of femoral neck in young adults.Methods From June 2006 to July 2012,76 patients with subcapital fractures of femoral neck were treated with a combination of sartorius musclc-pcdicle bone graft and cannulated lag screw internal fixation.The postoperative effect was evaluated by modified Harris hip scoring system.Results All the 76 patients were followed up.The postoperative radiographic outcome showed that 72 patients achieved union,wit a union rate of 94.7％ （72/76）.At the last follow up,according to modified Harris score system the results were excellent in 54,good in 12,poor in 10 cases,and the overall excellent and good rate was 86.9％.Conclusion Sartorius muscle pedicle bone graft is good in the management of subcapital fractures of femoral neck in young adults,for it helps to provide an additional source of blood supply,accelerate bony healing,reduce the rate of femoral head necrosis and improve fracture union.So it is an effective surgical procedure for the treatment of subcapital fractures of femoral neck.