早期关节内减压加自体红骨髓移植联合治疗青壮年股骨颈骨折的临床应用

Clinical Study of Early Joint Decompression and Autologous Red Bone Marrow Transplantation in the Treatment of Femoral Neck Fracture in Young Adults

目的探讨早期关节内减压加自体红骨髓移植治疗青壮年股骨颈骨折的临床效果。方法选取我院收治的经X线片检查确诊暴力导致的青壮年股骨颈骨折患者70例,随机分为观察组（35例）和对照组（35例）。对照组患者硬膜外麻醉,行闭合复位空心加压螺钉内固定治疗。观察组患者在对照组治疗的基础上,联合关节囊内多点穿刺减压和自体红骨髓移植。术后随访12~36个月,X线片复查判断骨折愈合和股骨头坏死情况,同时进行髋关节功能评分。结果观察组骨折不愈合率（0）显著低于对照组（11.43%）,观察组股骨头坏死率（2.86%）显著低于对照组（17.14%）,观察组Harris总分（88.6±9.8）分明显大于对照组（83.1±8.7）分,差异均有统计学意义（P〈0.05）。结论闭合复位空心加压螺钉内固定联合关节内减压和自体红骨髓移植,可显著降低青壮年股骨颈骨折的不愈合率和股骨头坏死率,提高患者髋关节功能。

Objective To investigate the clinical study of early joint decompression and autologous red bone marrow transplantation in the treatment of femoral neck fracture in young adults. Methods Seventy young adults with femoral neck fracture from June 2013 to January 2014 in our hospital were selected and divided into two groups with 35 cases of each group.Patients in control group were treated with Mc Elvenny traction closed reduction and internal fixation with hollow compression screws. The observation group patients were treated with Mc Elvenny traction closed reduction and internal fixation with hollow compression screw,combined with multiple point puncture decompression and autologous red bone marrow transplantation. After follow-upof 12 ~ 36 months,fracture healing and necrosis of the femoral head wereassessed,parallel Harris hip score were detected every 3 months. Results There was no fracture nonunion cases in the observation group,the fracture nonunion rate of the control group was 11. 43%（ P〈0. 05）. The rate of femoral head necrosis of the observation group and the control group was 2. 86% and 17. 14% respectively（ P〈0. 05）. The Harris score of the observation group（ 88. 6 ± 9. 8） was higher than the control group（ 83. 1 ± 8. 7）（ P〈0. 05）. Conclusion Mc Elvenny traction closed reduction and internal fixation with hollow compression screw,combined with multiple point puncture decompression and autologous red bone marrow transplantation can reduce the rate of femoral neck fracture nonunion and ischemic necrosis of femoral head,and improve hip function in patients.Itis worthy of popularization and application.