带旋股外动脉升支髂骨瓣加空心加压钉治疗股骨颈骨折

Combination of the implantation of pedicled iliac bone graft with ascending branch of lateral femoral circumflex artery and compression-screw internal fixation in treatment of femoral neck fractures

目的 :报道旋股外侧动脉升支髂骨瓣加空心加压螺钉治疗青壮年股骨颈骨折的手术方法及临床效果。方法 :在解剖学研究的基础上 ,设计并应用旋股外侧动脉升支髂骨瓣加空心加压螺钉治疗青壮年股骨颈骨折 3 6例。结果 :3 6例中 ,优 2 2例 ,良 11例 ,可 2例 ,差 1例。 3 3例骨折完全愈合 ,3例出现股骨头坏死 ,优良率 91.7%。结论 :该术式骨瓣血供丰富 ,固定牢靠 ,操作简便 ,创伤小 ,是治疗青壮年股骨颈骨折的一种有效方法。

Objective: To report a new way and study its clinical effects to treat the femoral neck fractures in young adults by implanting the pedicled iliac bone graft with ascending branch of lateral femoral circumflex artery combined with compression-screw internal fixation. Methods: The iliac bone graft was designed based on its blood supply, and 36 cases of femoral neck fractures which were treated by this graft from February 1993 to June 2000 were reviewed. These operations were all performed with compression-screw internal fixation at the same time. Results: All these cases were followed-up from 1.5 to 5.5 years. Among them, the ideal were 22, the good 11, the fair 2 and the poor 1. The fractures were healed completely in 33 cases, but femoral head necrosis occurred in 3 cases. The ideal and good rate of clinical effect was 91.7%. Conclusions: This method has the advantages of rich blood supply, firm fixation, simply operation and less invasive, which will reach reliable satisfactory clinical effects; therefore it is a sound and effective way to treat the femoral neck fractures in young adults.