髋臼骨折合并同侧股骨颈骨折的治疗

Treatment of Acetabular Fracture with Ipsilateral Femoral Neck Fracture (Report of 4 Cases)

目的 探讨髋臼骨折合并同侧股骨颈骨折的临床特点及治疗方法。方法 本组共4例患者,男3例,女1例,年龄17～63岁,平均年龄为43.6岁。均为闭合性骨折。髋臼骨折3例行重建钢板内固定,1例行拉力螺丝钉内固定;股骨颈骨折2例行空心螺钉内固定,1例行动力加压螺纹钉内固定,1例行全髋关节置换术。结果 4例患者随访14～67个月,平均39.3个月。优3例,良1例。结论 髋臼骨折合并股骨颈骨折为少见、复杂而严重损伤,常合并多部位、多系统损伤。应尽早行手术治疗,并根据两处骨折的不同类型选择手术次序及方案。手术治疗髋臼骨折合并股骨颈骨折是纠正移位、稳定骨折和改善关节功能的有效方法。

Objective To study the clinical characters and procedures for the treatment of acetabular fracture with ipsilateral femoral neck fracture. Methods In a group of 4 patients, there were 3 males and 1 female. The age of the patients ranged from17 to 63 years old with average age 43. 6 years old. All cases were closed fractures. For the treatment of acetabular fracture, 3 cases were treated with reconstructive plates and 1 case with dynamic screws. The cannulated screws were used for internal fixation in 2 cases, compressive screws in one case and THA was done in another case for the femoral neck fracture. Results Four patients were followed up for 14 to 67 months (average 39.3 months). Three cases had excellent result, one case had good result. Conclusion The acetabular fracture with ipsilateral femoral neck fracture is seldom, complex and serious injury. They usually complicated with multiple organs and systems in-volvment. The surgeries should be done on them as early as possible, on term of the different types of two positions fractures the sequence and program will be chosen. It is an efficient method and can reach a good fracture reduction, stablization and joint function by operation in acetabular fracture with ipsilateral femoral neck fracture.