可吸收螺钉治疗髋关节后脱位伴股骨头骨折  

Treatment of posterior hip dislocation with femoral head fracture using absorbable screw rod system

作　　者：陈熹[1] 夏天[1] 刘国辉[1] 吴永超[1] 刘毅[1] 查琨[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院骨科,武汉430022

出　　处：《中华创伤骨科杂志》2016年第5期396-400,共5页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨可吸收螺钉治疗髋关节后脱位伴股骨头骨折的临床疗效。方法回顾性分析2009年2月至2014年6月收治的20例髋关节后脱位合并股骨头骨折患者资料，男14例，女6例；平均年龄为38．2岁（27—60岁）；左髋8例，右髋12例；Pipkin骨折分型：Ⅰ型15例，Ⅱ型5例。受伤至手术时间平均为6d（3—14d）。所有患者均采用Allis手法复位可吸收螺钉固定治疗。结果本组患者的手术时间为1—6h，平均1．8h；术中出血量为70～400mL，平均160mL。20例患者术后获18—48个月（平均32个月）随访。所有患者骨折均获愈合，愈合时间为2．5～5．0个月，平均3．4个月。术后6个月按髋关节Harris评分标准评定疗效：优10例，良7例，可2例，差1例，优良率为85．O％。3例（可2例，差1例）患者术后关节疼痛未明显减轻，术后6个月发生股骨头缺血性坏死，已行全髋关节置换术。结论可吸收螺钉固定治疗髋关节后脱位伴股骨头骨折（PipkinⅠ、Ⅱ型）具有简化手术过程、减小创伤、固定牢靠、避免二次手术、减少术后并发症的发生等优点，是一种有效的治疗方法。Objective To investigate the efficacy of absorbable screw rod system in the treatment of posterior hip dislocation complicated with femoral head fracture. Methods Between February 2009 and June 2014, 20 patients were treated at our department for posterior hip dislocation complicated with femoral head fracture. They were 14 males and 6 females, with an average age of 38.2 years （range, from 27 to 60 years）. Eight left hips and 12 right hips were affected. By the Pipkin classification, 15 cases were type Ⅰ and 5 type Ⅱ. The time from injury to surgery ranged from 3 to 14 days （average, 6 days） . All of them were treated with absorbable screw rod system after Allis manual reduction. Results The operation time in this group ranged from 1 to 6 hours （average, 1.8 hours）. The intraoperative blood loss ranged from 70 to 400 mL （average, 160 mL）. They were followed up for 18 to 48 months （average, 32 months）. All the fractures u- nited after an average time of 3.4 months （range, from 2.5 to 5.0 months）. According to the Harris scores at 6 months postoperation, 10 cases were rated as excellent, 7 as good, 2 as fair and one as poor, with a good to excellent rate of 85.0%. Total hip replacement was performed for 2 fair and one poor cases because their postoperative pain was not relieved and femoral avascular necrosis developed. Conclusion Absorbable screw rod system is an effective treatment of posterior dislocation with femoral head fracture, because it can simplify operative procedures, reduce trauma, fixate the fracture firmly, avoid secondary operation, and re- duce postoperative complications.

关 键 词：髋脱位 股骨头 骨折固定术 内 骨钉 

分 类 号：R687.3[医药卫生—骨科学]