后壁的完整性对中青年移位股骨颈骨折空心钉内固定预后影响的研究  

Prognostic effect of integrity of posterior wall on displaced femoral neck fracture with cannulated screw fixation in young and middle-aged patients

作　　者：王志坤[1] 余占洪[1] 苏厂尧[1] 姚汉刚[1] 廖德允[1] 谢文伟[1] 

机构地区：[1]南方医科大学附属东莞石龙人民医院骨科,广东东莞523107

出　　处：《中国骨与关节损伤杂志》2015年第2期127-129,共3页Chinese Journal of Bone and Joint Injury

基　　金：广东省医学科研基金(B2013434)

摘　　要：目的探讨股骨颈后壁完整性对中青年移位股骨颈骨折闭合复位空心钉内固定预后的影响,为临床治疗提供参考。方法自2000-06—2009-02符合纳入和排除标准的移位股骨颈骨折120例,按股骨颈后壁的完整性分为2组,A组58例为移位但后壁完整的股骨颈骨折,B组62例为移位且后壁骨折的股骨颈骨折。记录2组复位后的Garden指数,骨折愈合时间,骨折不愈合例数,股骨头缺血性坏死例数,股骨颈短缩例数,骨折再次移位例数,改行髋关节置换术例数及时间。结果 120例术后至少随访5年。2组骨折复位后Garden指数差异无统计学意义(P>0.05)。A组在骨折愈合时间、术后并发症方面优于B组,差异有统计学意义(P<0.05)。A组11例于第1次术后(24.4±3.3)个月改行髋关节置换术,B组26例第1次术后(12.6±2.7)个月改行髋关节置换术,差异有统计学意义(P<0.05)。结论股骨颈后壁的完整性对于移位的股骨颈骨折内固定预后有重要的影响。Objective To assess the effect of femoral neck posterior wall integrity on prognosis of displaced femoral neck fractures with closed reduction and cannulated screw fixation in the young and middle-aged, provide the reference for the clinical treatment. Methods From June 2000 to February 2009, 120 cases of the displaced femoral neck fracture meeting the inclusion and exclusion criteria were included, and according to the integrity of the posterior wall of the femoral neck, were divided into 2 groups, 58 cases in group A as shift but unbroken posterior wall fracture of neck of femur, 62 cases in group B as shift and posterior wall fracture of the femoral neck fracture. After reduction, the Garden index, healing time of fracture,fracture nonunion cases of avascular necrosis of the femoral head, the number of cases, the number of cases of femoral neck fracture in short, once again shift cases, diverted the number and time of hip joint replacement patients in two groups were recorded. Results All the 120 patients were followed up for at least 5 years. There was no significant difference in Garden index after reduction of fracture between the 2 groups（P 0.05）. In group A, fracture healing time, postoperative complications was better than that of group B, the difference was statistically significant（ P 0.05）. Eleven cases in group A in the first postoperative（24.4±3.3）months received hip replacement, 26 cases in B group in the first postoperative（12.6 ±2.7）months underwent hip replacement, the difference was statistically significant（P 0.05）. Conclusion The integrity of the posterior wall of the femoral neck for displaced femoral neck fractures has important influence on prognosis.

关 键 词：股骨颈骨折 股骨颈后壁完整性 闭合复位 空心钉 内固定 中青年 

分 类 号：R687.3[医药卫生—骨科学]