不同骨瓣移植治疗青中年股骨颈骨折的临床效果比较  

Clinical effect comparison of different bone flap grafts in young and middle-aged patients with fracture of neck of femur

作　　者：温洪鹏 

机构地区：[1]广东省廉江市人民医院骨四区,广东廉江524400

出　　处：《中国当代医药》2015年第19期85-87,共3页China Modern Medicine

摘　　要：目的探究带血管蒂大转子骨瓣与股方肌骨瓣治疗股骨颈骨折的临床效果。方法回顾性分析2011年1月~2012年1月到本院治疗股骨颈骨折的患者18例,按照手术方法的不同分为A组即带血管蒂大转子骨瓣移植至股骨颈后方共8例,B组采用股方肌骨瓣移植至股骨颈后方共10例,两组均采用髋关节后外侧入路行切开复位中空拉力螺钉内固定。观察两组患者的临床疗效及并发症情况。结果两组病例随访8~35个月,均未有并发症发生,两组病例切口长度、手术时间比较,差异无统计学意义（P〉0.05）。A组术中失血量少于B组,且平均少31 ml,差异有统计学意义（P〈0.05）。A组移植骨瓣愈合时间较B组少0.9个月,差异有统计学意义（P〈0.05）。A组骨折愈合时间较B组少1.9个月,差异有统计学意义（P〈0.05）。两组术后1年Harris评分比较,差异无统计学意义（P〉0.05）,A组手术后股骨头坏死率较B组低,差异有统计学意义（P〈0.05）。结论带血管蒂大转子骨瓣移植治疗股骨头骨折较股方肌骨瓣移植愈合时间短,术中出血少,无股骨头坏死发生,临床效果显著,安全性高,值得临床推广。Objective To explore the clinical effect of vascularized greater trochanter bone graft and quadratus femoris muscle pedicle bone graft on treating femoral neck fracture, Methods From January 2011 to January 2012,18 patients with femoral neck fracture admitted into our hospital were retrospectively analyzed.According to different surgical methods,they were divided into group A （vascularized greater trochanter bone graft to posterior side of femoral neck;n=8） and group B （quadratus femoris muscle pedicle bone graft to posterior side of femoral neck;n=lO）.Open reduction by inter- nal fixation with cannulated screws was via posterior-lateral approach of hip joint in both groups.The clinical effect and complications between two groups was observed respectively. Results There was no complication occurred during 8 to 35 months follow up between two groups.The length of incision and operation time between two groups didn＇t display statistical difference（P〉0.05）.The amount of bleeding in group A was less than that in group B,less than 31 ml on average,with a statistical difference （P〈0.05）.With regard to healing time of grafting bone flap,the time in group A was 0.9 month less in comparison with that in group B,which displayed a statistical difference （P〈0.05）.On healing time of bone fracture,the time in group A was 1.9 months less compared with that in group B,with a statistical difference （P〈0.05）. There was no significant difference in Harris scoring one year after surgery （P〉0.O5）.In comparison with postoperative femoral head necrosis rate,the rate in group A was superior to that in group B,with a statistical difference （P〈0.05）. Conclusion In comparison with quadratus femoris muscle pedicle bone graft,in the treatment of fracture of head of femur,vascularized greater trochanter bone graft has advantages of short healing time,little amount of bleeding during surgery,non-occurrence of femoral head necrosis, remarkable clinical effect,and high safety,which is worthy of promo

关 键 词：带血管蒂大转子骨瓣 股方肌骨瓣 股骨颈骨折 

分 类 号：R687[医药卫生—骨科学]