股骨颈骨折伴股骨粗隆间骨折的手术治疗  

Treatment of Ipsilateral Femoral Neck and Intertrochanteric Fracture

作　　者：关鹏飞[1] 刘丙立[1] 李冀[1] 陈长河[1] 焦祥[1] 

机构地区：[1]河北省唐山市第二医院创伤科,063000

出　　处：《中国骨与关节损伤杂志》2011年第6期487-489,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的初步探讨空心钉加锁定加压钢板(LCP)治疗股骨颈骨折伴股骨粗隆间骨折的临床治疗效果。方法自2005年7月～2009年11月共收治股骨颈骨折伴股骨粗隆间骨折11例,均为新鲜闭合性骨折,所有患者行股骨颈空心钉加股骨粗隆间LCP内固定术治疗。结果 11例随访8～25个月,平均15.5个月;骨折临床愈合时间为12～28周,平均16周。所有患者均未出现感染、下肢深静脉血栓形成(DVT)、无髋内翻等畸形愈合,无钢板断裂、松动、断钉现象,术后发现股骨头坏死及股骨颈骨折不愈合各1例,均行全髋关节置换术(THA)。结论股骨颈空心钉结合LCP内固定治疗此类骨折的关键是使股骨颈骨折及股骨粗隆内侧骨块尽可能解剖复位,术中宜减少软组织的剥离,避免术后过早负重。Objective To discuss the u＇eatment of ipsilateral intertrochanteric and femoral neck fracture fixed by locking compression plate （LCP） and hollow screws. Methods There were 11 ipsilateral intertrochanteric and femoral neck fresh closed fracture cases from July 2005 to November 2009 in our hospital. The cases included 5 males and 6 females, ageing 41 to 86 years old with an average of 68.7 years old. In all cases the femoral neck fractures were fixed by hollow screws and intertrochanteric fracture were fixed by LCP. Results Eleven cases were followed up for 8 to 25 months with an average of 15.5 months. The fracture healing time was 12 to 28 weeks, average 16 weeks. All cases had no infection, deep venous thrombosis and hip varus malunion. The implant had no rupture, loosening or breakage phenomenon. There was 1 case in which femoral head was necrosis and 1 case in which femoral neck fracture was nonunion underwent to- tal hip arthmplasty（THA）. Conclusion The femoral neck fracture fixed by hollow screws and intertrochanteric fractures fixed by LCP can achieve good clinical results. The key of operation is to reduce soft tissue dissection and provide a anatomic reduction as possible. After surgery avoiding early weight bearing is one of the keys to successful operation.

关 键 词：股骨颈骨折 股骨粗隆间骨折 空心钉 锁定加压钢板 

分 类 号：R683.42[医药卫生—骨科学]