股骨干骨折合并同侧股骨颈骨折治疗的临床观察  

Treatment for ipsilateral fractures of the femoral neck and shaft

作　　者：刘少军[1] 何伟[1] 张德兴[1] 樊粤光[1] 

机构地区：[1]广州中医药大学第一附属医院髋关节疾病治疗中心,广东广州510405

出　　处：《中国骨伤》2008年第5期343-345,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨股骨干合并同侧股骨颈骨折的治疗特点和不同固定方法的疗效。方法:股骨干骨折合并同侧股骨颈骨折27例,男22例,女5例;年龄14～65岁,平均35岁。动力髋螺钉(DHS)固定3例,加压钢板加空心加压螺钉固定12例,重建钉固定8例,顺行髓内钉加空心加压螺钉固定4例。13例固定术前用克氏针临时固定股骨颈骨折。结果:术后随访36～75个月,平均44个月。25例股骨颈骨折平均愈合时间4.5个月,2例股骨颈骨折不愈合。27例股骨干均愈合,平均愈合时间6个月。未用克氏针临时固定股骨颈骨折14例中,2例出现股骨颈不愈合,3例轻度髋内翻畸形。结论:股骨干合并同侧股骨颈骨折有许多固定方法可供选择,加压钢板加空心加压螺钉固定简便易用,在实施固定术前用克氏针临时固定股骨颈骨折可避免股骨颈骨折再移位和损伤。Objective.To investigate the curative effect of different internal fixation for ipsilateral fractures of the femoral neck and shaft. Methods：By retrospective study of 27 patients who sustained ipsilateral femoral shaft and neck fractures from June 1993 to March 2004. There were 22 male and 5 female ,with an average age of 35 years（range in 14 to 65 years）. The femoral neck and shaft fractures were stabilized with dynamic hip screw system （DHS） in 3 cases ,with dynamic compression plate and cannulated lag screw in 12 cases,with constructive nail in 8 cases,with antegrade intramedullary locking nail and cannulated lag screw in 4 cases. There were 13 cases used of the temporary fixation of Kirschner wire before the pexia of the femoral neck fractures. Results： All of the patients were followed up for 36 to 75 months, with an average of 44 months. The average healing period of femoral neck fracture was 4.5 months in 25 cases, nonunion of femoral neck fractures in 2. The average healing period of femoral shaft fracture was 6 months in 27 cases. In 14 cases that not using temporary fixation of femoral neck with Kirschner wire, there were nonunion of femoral neck in 2 and slight coxa vara in 3. Conclusion ： There are a wide choice of internal fixation method for treatment of ipsilateral fracture of the femoral neck and shaft, the fixation with dynamic compression plate and cannulated lag screw is a handy method. It would be avoided to the replacement and trauma, temporary fixing the fracture with Kirschner wire before the pexia of the femoral neck fracture.

关 键 词：股骨干骨折 股骨颈骨折 骨折固定术 内 

分 类 号：R683.42[医药卫生—骨科学] R730.26[医药卫生—外科学]