青壮年股骨颈骨折复位技巧和内固定选择  

Reduction techniques and choice of internal fixation for young femoral neck fractures

作　　者：姜达君 贾伟涛[1] 张长青[1] Jiang Dajun;Jia Weitao;Zhang Changqing(Department of Orthopedic Surgery,The Sixth People＇s Hospital of Shanghai,Shanghai Jiaotong University,Shanghai 200233,Chin)

机构地区：[1]上海交通大学附属第六人民医院骨科,200233

出　　处：《中华创伤骨科杂志》2018年第7期588-593,共6页Chinese Journal of Orthopaedic Trauma

基　　金：上海市教委高峰临床医学资助基金（20172026）;上海人才发展资金（2017035）

摘　　要：青壮年股骨颈骨折发生率不高，仅占此骨折类型患者的3％。但是青壮年股骨颈骨折多由高能量暴力所致，血供与力学环境较差，有更高的骨不连、股骨头缺血坏死风险，且青壮年患者术后功能需求比较高，因此青壮年股骨颈骨折一直是临床函待解决的热点问题。本文针对该类型骨折，详细介绍了股骨颈骨折复位技巧与标准，对比不同内固定选择之间的优势与不足，阐述了此类骨折及其特殊类型如延迟性、陈旧性股骨颈骨折或骨不连的治疗方法及理念的最新进展，并提出了一些仍待解决的争议点。对于青壮年股骨颈骨折的处理需要我们深入了解其解剖与生物力学特点，总体上把握其处理原则，根据研究结果循证运用各种手术及内固定方式才能提高临床疗效，促进患者快速康复，恢复髋关节功能。Femoral neck fractures are not common in young patients, accounting for merely 3% of all these fractures. However, since the young femoral neck fractures are mostly caused by high energy violence, they usually jeopardize local blood supply and mechanical environment, resulting in higher risks of non-union and avaseular necrosis. Besides, young patients often make a greater demand for functional recovery. Con- sequently, young femoral neck fracture is always a clinical challenge. In this article, we introduce in details the latest techniques and standards for reduction of young femoral neck fracture, compare advantages and drawbacks of various internal fixations, illustrate up-to-date progress in treatment methods and concepts for delayed and nonunited femoral neck fractures, and lastly put forward some unsolved issues open to dispute. In treatment of young femoral neck fractures, it is necessary for us to get familiarized with their anatomy and biomeehanical characteristics, grasp the principles of treatment on the whole, and choose operational and internal fixation methods based on the clinical evidence before we can improve therapeutic efficacy, accelerate rehabilitation progress and restore function of the hip joint as much as possible.

关 键 词：股骨颈骨折 骨折固定术 内 治疗 青壮年 

分 类 号：R687.3[医药卫生—骨科学]