16例中青年股骨头骨折的临床治疗  

Clinical effect of femoral head fractures in 16 young and middle-aged patients

作　　者：欧钜伦[1] 许国泰[1] 桂景雄[1] 郭胜[1] 邓志成[1] 

机构地区：[1]南方医科大学附属小榄医院骨二科,广东中山528415

出　　处：《生物骨科材料与临床研究》2015年第4期29-32,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的 探讨和总结中青年股骨头骨折治疗的临床疗效.方法 随访我院自2001年2月～2012年5月手术治疗的16例中青年股骨头骨折病例,男12例,女4例;年龄23～54岁,平均（38.39±8.63）岁.Pipkin Ⅰ型5例;Ⅱ型7例;Ⅲ型1例;Ⅳ型3例.采用Smith-Peterson入路10例,Kocher-Langenbock入路4例,Moore入路2例.骨块摘除3例,拉力螺钉固定13例,3例合并髋臼后壁骨折病例中2例采用重建钢板内固定,1例采用铆钉固定.结果 平均随访时间为（40.1±8.56）月（25.1～50月）,所有骨折均愈合,无感染发生,无内固定失败,无接受髋关节置换的病例.按照Merle d＇Aubigne和Postel评分,优良率为（9/16） 56.3％,中（3/16） 18.7％,差（4/16）25％.4例患者发生股骨头内固定术后缺血性坏死,5例患者发生了异位骨化,1例继发创伤性关节炎.结论 运用空心螺钉治疗中青年股骨头骨折可获得满意的早期疗效,但股骨头骨折术后并发症发生率相对较高,需对术后髋部功能进行长期随访.Objective To explore and summarize the clinical effect of femoral head fractures in young and middle-aged patients. Methods 16 young and middle-aged patients, operated in our hospital between February 2001 and May 2012, were followed up, there were 12 males, 4 females, aging from 23 to 54 years old, with an average age of （38.39±8.63）. Of them 5 Pipkin type I cases; type II 7 cases; typeIII 1 case; type IV 3 cases. Smith-Petcrson approach was used in 10 cases, KocherLangenbock approach in 4 cases, Moore approach in 2 cases. Bone blocks excision in 3 cases, canulated screw fixation in 13cases, 2of 3 cases with posterior wall fracture ofacetabulum were treated with reconstruction plates, the other one was fixed with rivets. Results The mean duration of follow-up was （40.1＋8.56） months, so far, no patient has accepted hip arthroplasty, all patients receiving internal fixation healed with no infection, no internal fixation failure, according to the Merle d＇Aubigne and Postel scores, the fineness rate was 56.3% （9/16）, medium 18.7% （3/16）, poor 25% （4/16）. Femoral head avascular necrosis happened in 4 patients after internal fixation, heterotopic ossification occurred in 5 patients, secondary traumatic arthritis was found in 1 case. Conclusion Satisfactory early results could be acquired, with the using of canulated screw in femoral head fractures among the young and middle-aged people, as the postoperative complications incidence of femoral head fractures is relatively high, long-term follow-up is needed to evaluate the postoperative function of injured hips.

关 键 词：股骨头骨折 空心螺钉 髋关节脱位 

分 类 号：R687.3[医药卫生—骨科学]