直接前侧入路内侧支撑钢板联合空心螺钉治疗青壮年Pauwels Ⅲ型股骨颈骨折的效果

Curative Effect of Medial Buttress Plate Augmentation of Cannulated Screw Through Direct Anterior Approach in the Treatment of Pauwels Ⅲ Femoral Neck Fractures in Young Adults

目的探讨直接前侧入路内侧支撑钢板联合经皮空心螺钉治疗青壮年Pauwels Ⅲ型股骨颈骨折的临床效果。方法收集2015年6月至2020年10月许昌市中心医院骨科收治的11例闭合性Pauwells Ⅲ型青壮年股骨颈骨折患者的临床资料。其中,男7例,女4例,年龄19-58岁,平均42.5岁。患者均接受直接前侧入路内侧支撑钢板联合经皮空心螺钉固定。术后随访观察患者股骨颈骨折愈合、内固定复位丢失、髋关节功能Harris评分以及股骨头缺血坏死等情况。结果所有患者均获得随访,随访时间6-24个月,平均18.4个月。末次随访股骨颈骨折均一期愈合,内固定位置可,无内固定复位丢失、股骨头缺血性坏死等并发症。髋关节功能Harris评分72-95(86.20±5.25)分,优7例,良2例,优良率为81.82%。结论采用直接前侧入路内侧支撑钢板联合空心螺钉治疗青壮年Pauwels Ⅲ型股骨颈骨折的短期效果显著,可维持股骨颈骨折断端复位,减少术后并发症。

Objective To investigate the clinical effect of medial buttress plate augmentation of cannulated screw through direct anterior approach in the treatment of pauwels Ⅲ femoral neck fractures in young adults.Methods From June 2015 to October 2020,11 cases of closed pauwels Ⅲ femoral neck fractures in young adults were retrospectively analyzed in Xuchang Central Hospital.Among them,there were 7 males and 4 females,aged from 19 to 58 years old,with an average of 42.5 years old.All patients were treated with medial buttress plate augmentat ion of cannulated screw through direct anterior approach.The healing of femoral neck fracture,loss of internal fixation and reduction,Harris score of hip joint function and avascul ar necrosis of femoral head were observed after operation.Results All cases were followed upfor 6 to 24 months,with an average of 18.4 months.In the last follow-up,all femoral neck fractures healed in the first stage,and the internal fixation position was acceptable,without any complications such as loss of internal fixation reduction and avascular necrosis of femoral heads.Harris score of hip joint function was 72 to95(86.20+5.25)points.The results were excellent in 7 cases and good in 2 cases,and the excellent and good rate was 81.82%.Conclusion The short-term effect of medial buttress plate augmentation of cannulated screw in treatment of Pauwels Ⅲ femoral neck fractures in young adults through direct anterior approach approach is remarkable,which can maintain good fracture reduction and reduce the incidences of postoperative complications.