老年GardenⅢ与Ⅳ型股骨颈骨折闭合复位内固定术疗效比较

Comparison of the Curative Effect of Closed Reduction and Internal Fixation with Cannulated Screws for Garden Ⅲ and Garden Ⅳ Femoral Neck Fractures in the Elderly

目的：探讨内固定术治疗老年移位型股骨颈骨折的疗效。方法：回顾性分析2005年9月-2010年9月河南省骨科医院髋部损伤一科采用闭合手法复位空心钉内固定术治疗的133例老年移位型股骨颈骨折患者的临床资料，GardenⅢ型组73例，GardenⅣ型组60例。比较两组治疗结果及疗效。结果：随访26～120个月，平均62个月。两组患者股骨头坏死率及疗效比较差异均有统计学意义（P〈0.05）。GardenⅢ型组骨折愈合率93.2%，股骨头坏死率11.0%，髋关节功能Harris评定优良率89.0%。结论：老年移位型股骨颈骨折术后股骨头坏死与移位程度相关。老年GardenⅢ型股骨颈骨折，可选择性采取闭合复位内固定术治疗。

Objective：To retrospectively study and compare the effect of GardenⅢ vs GardenⅣ femoral neck fracture in elderly treated by internal fixation.Method：A total of 133 patients of GardenⅢ（73 cases）and GardenⅣ（60 cases）femoral neck fractures in elderly which treated by closed reduction and internal fixation with cannulated compression screws from September 2005 to September 2010 in Orthopedic Hospital of He’nan Province were retrospectively analyzed.Treatment outcome and curative effect between GardenⅢ group and GardenⅣ group were analyzed by statistic system.Result：Followed up from 26 to 120 months with average 62 months,there existed significant difference in femoral head necrosis and effect between two groups（P〈0.05）.Fracture union rate of GardenⅢ group in 93.2%,necrosis rate of femoral head in 11.0%,and hip function better and excellent in 89.0%according to Harris hip joint score.Conclusion：Femoral head necrosis of displaced femoral neck fracture in elderly concerns the degree of it’s fracture displacement.GardenⅢ femoral neck fracture in elderly can selectively treated by closed reduction and internal fixation.