前方小切口辅助复位空心钉内固定治疗Garden Ⅲ、Ⅳ型股骨颈骨折  

Clinical research of Garden type Ⅲ and Ⅳ femoral neck fracture treated by using small anterior incision and hollow screw fixation

作　　者：卢海燕[1] 唐聪[1] 范华强[1] 张少战[1] 胡喜春[1] 付仰攀[1] 李鸿达[1] 黄长明[1] 

机构地区：[1]解放军第174医院(厦门大学附属成功医院)骨科,福建厦门361003

出　　处：《中国骨与关节损伤杂志》2017年第7期715-717,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨前方小切口辅助复位空心钉内固定治疗Garden Ⅲ、Ⅳ型股骨颈骨折的手术技巧及疗效。方法回顾性分析自2006-01—2015-01采用前方小切口辅助复位空心钉内固定治疗的57例Garden Ⅲ、Ⅳ型股骨颈骨折。术后摄正侧位X线片测量Garden指数评定骨折复位质量。末次随访时采用髋关节功能Harris评分评定疗效。结果本组手术时间45~110 min,平均69 min;术中出血量40~350 ml,平均120 ml。57例均获得随访6~60个月,平均18.7个月。术后采用Garden指数评定骨折复位质量:Ⅰ级复位11例,Ⅱ级复位42例,Ⅲ级复位3例,Ⅳ级复位1例。末次随访时髋关节功能Harris评分:优34例,良14例,可5例,差4例,优良率85.7%。结论采用前方小切口辅助复位3枚空心钉内固定治疗Garden Ⅲ、Ⅳ型股骨颈骨折时,结合复位、置钉技巧,操作简单,创伤小,内固定可靠,可取得满意疗效。Objective To investigate the technique and clinical therapeutic effect of the small anterior incision and hollow screw fixation on femoral neck fracture （Garden type Ⅲ and Ⅳ）. Methods From January 2006 to January 2015, 57 patients with femoral neck fractures（Garden type Ⅲ and Ⅳ） were treated with the combination of small incision in front of the hip and hollow screw internal fixation. The clinical data of 57 patients were analyzed retrospectively. The quality of fracture reduction was assessed according to the Garden classification after operationl The Garden index was measured according to the postoperative posteroanterior and lateral radiograph. The clinical results were assessed according to the Harris scores at the last time of the follow-up. Results The average operation duration was 69 minutes （range, 45-110 min）, the ave/age blood loss was 120 ml （range, 40-350 ml）. All patients were followed up for mean 18.7 months （range, 6-60 months）. According to the Garden index,reduction reached gradeⅠ in 11 patients, grade Ⅱ in 42 patients, grade Ⅲ in 3 patients, and grade IV in 1 patient. At the last time of the follow-up, the Harris score was excellent in 34 cases, good in 14 cases, fair in 5 cases and poor in 4 cases with an excellent and good rate of 85.7%. ConcluSion The application of small incision in front of the hip and hollow screw internal fixation, to treat femoral neck＂ fracture （including Garden type Ⅲ and Ⅳ） has the advantages-of simple operation, little trauma, reliable fixation, high healing rate of fractures and good curative effect.

关 键 词：股骨颈骨折 GARDEN分型 前方小切口 空心钉 内固定 

分 类 号：R687.3[医药卫生—骨科学]