高选择性血管造影预测青壮年股骨颈骨折预后的临床研究  

Clinical Study of Predicting Femoral Neck Fracture Prognosi By Superselective Digital Subtraction Angiography

作　　者：刘洋[1] 陈方舟[1] 李明辉[1] 袁希[2] 蔡林[3] 

机构地区：[1]湖北省武汉市第五医院骨科(江汉大学附属第二医院),430050 [2]湖北省武汉市第五医院放射科(江汉大学附属第二医院),430050 [3]武汉大学中南医院骨科

出　　处：《中国骨与关节损伤杂志》2010年第12期1069-1071,共3页Chinese Journal of Bone and Joint Injury

基　　金：湖北省武汉市卫生局科研基金资助(WX08D24)

摘　　要：目的探讨合适的股骨颈骨折分型方法,准确预测预后。方法对45例青壮年单侧股骨颈骨折采用高选择性血管造影技术(DSA),根据DSA结果进行分型:造影显示越过骨折线3～6支支持带血管影为Ⅰ型;显示1～2支血管影为Ⅱ型;没有越过骨折线血管支显影为Ⅲ型。均在C型臂X线机指导下行闭合空心钉内固定。术后根据症状及影像学,如X线、CT、MRI或DSA来判断股骨头坏死和骨折愈合情况。结果 DSAⅠ型股骨头坏死率为0,骨折不愈合率为13.33%,Ⅱ型股骨头坏死率为7.14%,骨折不愈合率为7.15%,Ⅲ型股骨头坏死率为100%,骨折不愈合率为0。结论①术后并发股骨头坏死的发生率和DSA显示的血管数量成负相关,与年龄成反比;②骨折不愈合的发生与年龄成正比,与DSA显示的血管数量无关联;③DSA对预测股骨颈骨折的预后有一定的指导价值。Objective To investigate suitable methods of classification of femoral neck fracture and prediction of prognosis.Methods Fourty-five young patients with single femoral neck fracture were all used DSA and divided into three types by DSA.Type Ⅰ was that DSA showed 3 to 6 supporting band vascular images cross fracture line.Type Ⅱ was that DSA showed 1 to 2.Type Ⅲ was that DSA did not show vascular images cross fracture line.All cases were given internal fixation operation by hollow screw under C-brachial machine.Vascular necrosis of femoral head（ANFH） and fracture healing were evaluated according to symptom and imaging examination.Results DSA typeⅠ,Ⅱ and Ⅲ were 0;7.14 and 100 percent in the rate of ANFH respectively.The rate of fracture union,13.3;7.15 and 0 percent respectively.Conclusion First,vascular amount of DSA showing is negative relation with the rate of ANFH and is inverse proportion to age.Second,fracture union after femoral neck fracture is direct ratio with age and is independent of vascular amount of DSA showing.Third,DSA has some direction value to predicting prognosis of femoral neck fracture.

关 键 词：高选择性血管造影 股骨颈骨折预后 预测 

分 类 号：R683.42[医药卫生—骨科学]