闭合复位股骨近端空心钉锁定板固定治疗青壮年移位股骨颈骨折

Treatment of displaced femoral neck fracture in young adults with close reduction and femoral neck locking plate fixation

目的 ：探讨闭合复位股骨近端空心钉锁定板固定治疗青壮年移位股骨颈骨折的临床疗效。方法 ：2010年8月至2014年8月采用闭合复位股骨近端空心钉锁定板固定治疗青壮年移位股骨颈骨折54例,男34例,女20例;年龄18~55岁,平均39.8岁。对股骨颈骨折的愈合率及短缩情况进行了记录观察,并按Harris评价标准对髋关节功能进行评价。结果：54例均获随访,时间4~24个月,平均11.3个月。骨折愈合率94.4%,愈合时间3~6个月,平均4.1个月。骨折愈合的51例患者,股骨颈短缩中位数0.8 mm,平均（0.48±0.46）mm。随访期间无感染、内固定物移位、脱出等并发症。按Harris标准评价：优40例,良9例,可2例,差3例。结论：闭合复位股骨近端空心钉锁定板固定可靠,有效避免了股骨颈短缩,骨折愈合率高,功能恢复好,是治疗青壮年移位股骨颈骨折的一种有效方法。

Objective：To investigate the clinical effects of close reduction and proximal femoral locking plate fixation for the treatment of femoral neck fractures in young adults. Methods：From August 2010 to 2014 August,54 patients with displaced femoral neck fracture were treated with closed reduction and proximal cannulated screw locking plate fixation. There were 34 males and 20 females,aged from 18 to 55 years with an average of 39.8 years. The informations of fracture healing and complications were recorded after operation. According to Harris criteria,the function of hip joint was evaluated. Results：All patients were followed up from 4 to 24 months with an average of 11.3 months. Three cases occurred fracture nonunion,fracture union rate was 94.4%（51 / 54）,union time was from 3 to 6 months with an average of 4.1 months. Among the healed 51 cases,the median of femoral neck shorten was 0.8 mm with the mean of（0.48±0.46） mm. No complications such as infection,internal fixation displacement were found during follow-up. According to Harris criteria,40 cases obtained excellent results,9 good,2fair,3 poor. Conclusion：Close reduction and proximal femoral locking plate fixation is an effective method in treating femoral neck fracture in young adults,it has advantages of avoiding the femoral neck crispation,reliable fixation,high rate of fracture union and good functional recovery.