青壮年股骨颈骨折不同手术方法疗效分析

Therapeutic Methods for Femoral Neck Fracture in Young Patients

目的 对不同方法治疗青壮年股骨颈骨折的疗效进行分析探讨。 方法 116例患者中 ,GardenⅠ～Ⅱ型 13例 ,采用多根螺纹钉或空心螺钉固定 ;Ⅲ～Ⅳ型患者 10 3例 ,采用切开复位内固定术 4 4例 ,切开复位内固定加带肌蒂骨瓣或带旋髂深血管髂骨瓣 5 9例。 结果 内固定加带肌蒂骨瓣或带旋髂深血管蒂髂骨瓣治疗 ,优良率显著高于其它单纯内固定组 (P <0 .0 1) ,骨折不愈合和股骨头坏死发生率明显低于单纯内固定组 (P <0 .0 1)。 结论 内固定加带肌蒂骨瓣或带旋髂深血管蒂髂骨瓣植入是治疗青壮年股骨颈骨折的较理想方案。

Objective To study the clinical effect of treating femoral neck fracture with different ways in the young patients. Methods 116 cases of femoral neck fracture were analyzed. According to the modified Garden grading system, 13 patients were classified as grade Ⅰand Ⅱ, and were fixed with screws. 103 patients were classified as grade Ⅲ and Ⅳ. 44 cases underwent internal fixation (group 1),and 59 cases had muscle pedicle bone flap or pedicle bone flap with deep circumflex iliac artery transplanted(group 2). Results The treatment of group 2 was more effective than that of group 1 ( P <0.01),and group 2 had less fracture nonunion and lower death rate of femoral neck. Conclusion For the femoral neck fracture, it is the first choice to transplant muscle pedicle bone flap or deep circumflex iliac artery in the young patients.