空心钉内固定治疗老年股骨颈骨折疗效观察  

Femoral Neck Fracture Treatment by Cannulated Screw Internal Fixation in Elderly Patients

作　　者：叶小雨 林初勇 张长松 沈新升 

机构地区：[1]温州市中西医结合医院骨科,浙江温州325000

出　　处：《实用骨科杂志》2007年第4期205-207,共3页Journal of Practical Orthopaedics

摘　　要：目的评价老年股骨颈骨折空心钉内固定预后的影响因素，内固定治疗老年股骨颈骨折的可行性。方法空心钉经皮手术内固定治疗老年股骨颈骨折62例，男25例，女37例，年龄60～85岁，平均68．65岁。无移位骨折（GardenⅠ、Ⅱ型）28例，移位骨折（GardenⅢ、Ⅳ型）34例，随访时间8～74个月，平均36．4个月。观察内容包括受伤至手术的时间、移位程度、术后早期负重及与年龄的关系。结果无移位股骨颈骨折，骨折不愈合及股骨头缺血坏死发生率为0，移位骨折，不愈合及股骨头缺血坏死分别占8．82％（3／34）和14．71％（5／34）。伤后至手术时间超过3周，骨折不愈合的发生率增高至50％（1／2）。结论如术前能掌握好适应证，术后给予正确的康复指导，内固定治疗老年人股骨颈骨折大多数效果良好。Objective To study the factors that influence the outcome of the femoral neck fractures after fixed by eannulated screws,and the possibility of internal fixation as otie of the useful methods in the treatment of femoral neck fractures. Methods Sixty-two elderly patients with femoral neck fractures were treated with pereutaneous cannulated screw fixation. Their average age was 68. 65 years （range, 60≈ 85years ）, Twenty-eight cases were femoral neck fractures with no displace （Garden Ⅰ , Ⅱ ）. Thirty-four cases were displaced （Garden Ⅲ , Ⅳ ）. The average follow up time was 36.40 months（8-74 months）. The time to surgery,initial fracture displacement ,weight bearing and age were recorded. Results The rate of nonunion and avaseular necrosis was 0.00% in the femoral neck fractures with no displace,while it was 8.82% （3/34） and 14. 71% （5/34） respectively in the displaced femoral neck fractures, the nonunion rate increased to 50.00% when the operation was delayed more than 3 weeks. Conclusion The outcome of internal fixation of femoral neck fractures is good in the majority of elderly patients. The indications should be mastered before operation and rehabil exercise guidance should he given postoperatively.

关 键 词：老年 股骨颈骨折 内固定 空心钉 

分 类 号：R683.42[医药卫生—骨科学]