应用多针和空心钉导针体外定位导向器内固定治疗股骨颈骨折

Application of External Guide and Localization of Hollow Screw and Pins for Tretment of Femoral Neck Fracture

目的 报道自行研制的“多针和空心钉导针体外定位导向器”的优点和“钉针组合法”治疗股骨颈骨折的整体力学优势及生物力学原理。方法 应用多针和空心钉导针体外定位导向器穿针内固定治疗股骨颈骨折60例。结果 穿针满意率100％,钉针在头颈内均立体交叉扇形分布成桁架结构。随访时间1～2年(平均20个月)。愈合时间8～20周,平均12周,愈合率100％,股骨头坏死率1.66％,功能优良率96.7％。结论 应用多针和空心钉导针体外定位导向器穿针,实现了大粗隆下骨皮质外缘套管射线定位法多针和导针一次定位导向准确,穿针一次成功率高,手术创伤小。通过优化钉针空间构型,最大限度发挥了钉针各自力学优势。且利于骨折端再血管化,提高了骨折愈合率,降低了股骨头坏死率。

Objective To introduce the advantages of external guide and localization of hollow screw and pins and its the biomechanical principle for treating femoral neck fracture. Methods The external guide and localization of hollow screw and pins was used in 60 cases of femoral neck fracture. Results The satisfactory rate was 100% . In femoral head and neck, these screw and pins were distributed according to three - dimensional, crisscross structure. The follow -up stage was 1 - 2 years with an average of 20 months. The bone union time was 8 - 20 week, the average 12 week. Fracture union rate was 100% . The satisfactory rate of function was 96.7 %. Conclusion Its rate of accuracy and success were high in using the external guide and localization of hollow screw and pins, and operation could be reduced or remitted the injury of X ray. It is one of the best internal fixation for femoral neck fracture in accord with biomechan-ics, raising rate of union and reducing rate of femoral head necrosis.