内固定加带血管肌蒂骨瓣移植治疗股骨颈骨折

Treatment of Femoral Neck Fractures by Tensor Fascia Latae Pedicle Iliac Bone Graft and Internal Fixation of Compressed Hollow Screws and Pin

目的:研究提高股骨颈骨折愈合率、降低股骨头坏死率的治疗手段 方法:采用切开复位、中空加压螺纹钉、骨圆针内固定加带旋股外侧动脉升支和阔筋膜张肌蒂髂骨瓣植骨治疗股骨颈移位骨折 结果:术后随访1～9年共46例,发生骨折不愈合3例、股骨头缺血坏死4例,其他无严重并发症 根据X光片和功能恢复情况分析:优24例(占52.17%)、良15例(占32.61%)、可3例(占6.52%)、差4例(占8.70%),功能恢复满意率为91.30% 结论:带旋股外侧动脉升支血管和阔筋膜张肌蒂髂骨瓣移植给缺血的股骨头引入血供,能促进股骨颈骨折愈合。

Objective: To explore an effective method of improving the union rate of femoral neck fractures and decreasing the rate of femoral head necrosis. Methods: 46 cases of displaced fracture of the femoral neck were treated by tensor fascia latae pedicle iliac bone graft with the lateral femoral circumflex artery and internal fixation of compressed hollow screws and pin through open reduction. Results: All cases were followed up for 1 to 9 years, 3 of which were non-union, 4 were aseptic necrosis, and no other complication occurred. According to the X-ray and functional recovery, 24 were excellent, 15 good, 3 fair and 4 poor,the functional recovery satisfactory rate were 91.3%. Conclusion: Tensor fascia latae pedicle iliac bone graft with lateral femoral circumflex artery takes reliable blood supply to femoral head. It has the advantage of improving the union of femoral neck fracture and decreasing the femoral head necrosis and non-union.