相对撬拨复位治疗嵌插向前成角的股骨颈骨折的疗效分析  

Clinical effect of the relative poking reduction for the treatment of the femoral neck fractures with insertion and forward angle

作　　者：杨德福 夏丽平 

机构地区：[1]大丰同仁医院骨科,江苏盐城224100

出　　处：《中国骨伤》2016年第11期1001-1004,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的：探讨经皮克氏针相对撬拨复位技术纠正难复性嵌插并向前成角的股骨颈骨折的复位效果及近期临床疗效。方法：回顾性分析2012年1月至2015年9月收治的外伤性股骨颈骨折的临床资料,选择骨牵引并抬高远端仍不能消除骨折端成角畸形的15例患者,男5例,女10例;年龄44-72岁,平均60.06岁。按Garden分型均为Ⅲ型。通过经皮克氏针相对撬拨复位方法纠正向前成角并用空心钉固定。手术前后摄X线片,分析复位质量（Garden指数评价）、短缩程度及股骨头是否坏死,按照Harris评分评价患者髋关节功能。结果：患者切口全部Ⅰ期愈合,无合并肺部感染及深静脉血栓。15例患者均获随访,时间6个月-3.0年,骨折全部愈合,1例发生局限性股骨头坏死。骨折复位按照Garden对线指数,Ⅰ级14例,Ⅱ级1例。正位X线片测量短缩1-5 mm,平均（2.73±1.37）mm。功能评定按Harris评分标准,末次随访疼痛、功能、畸形、关节活动度评分分别为42.1±2.5、37.2±4.6、3.2±0.5、4.1±0.3,总分为86.6±9.5;优良13例,可1例,差1例。结论：经皮克氏针相对撬拨复位技术纠正难复的嵌插并向前成角的股骨颈骨折,操作简单,可重复性强,达到了精准的复位要求;髋关节周围血供影响小,为骨折愈合提供了有利条件。Objective：To explore the reduction and clinical effect in the near future of percutaneous K wire relative poking reduction techniques for difficult to reduction of complex insert and forward angulation femoral neck fracture. Methods：The clinical data of traumatic femoral neck fractures treated in our hospital from January 2012 to September 2015 were retrospective analysis,15 patients with skeletal traction and distal elevation still can not eliminate the fracture angulation deformity were treated by percutaneous K wire relative poking reduction technique to correct the angular and using cannulated screw fixation,including 5 males and 10 females,aged from 44 to 72 years with an average of 60.06 years old. The fractures were Garden type III. The reduction effect was evaluated according to Garden alignment index and clinical evaluation in the near future outcome was assessed according to Harris Hip Score. Results：All patients were healed by first intention without pulmonary infection and deep vein thrombosis. The patients were followed up for 6 months to 3 years,all the fractures healed,and 1 case had limited necrosis of the femoral head. According to Garden alignment index,14 cases were level I reducation,and 1 case was level II. Limb shortening was 1 to 5 mm with an average of（2.73±1.37） mm. Functional evaluation according to Harris score standard,at the latest follow up the average value of pain,function,deformity and joint activity were 42.1±2.5,37.2±4.6,3.2±0.5,4.1 ±0.3,the total average value was 86.6 ±9.5;13 cases were excellent,1 case was good,1 case was poor. Conclusion：Percutaneous K wire relative poking reduction technique to correct the difficult to reduction of complex insert and forward angulation of the femoral neck fracture is simple,repeatable,and achieve the precision of the reset;the effect of blood supply of the hip joint is small,which provides favorable conditions for fracture healing.

关 键 词：股骨颈骨折 骨折固定术 内 经皮复位 

分 类 号：R614.4[医药卫生—麻醉学]