新型股骨颈动力加压锁定钉板系统治疗股骨颈骨折  

Evaluation of Kangli hollow screws with sliding compression locking plate system for treatment of femoral neck fractures

作　　者：胡家朗 李绍刚 陈明 李鲲 徐敏超 王俊文[1] 郑琼[1] 勘武生[1] Hu Jialang;Li Shaogang;Chen Ming;Li Kun;Xu Minchao;Wang Junwen;Zheng Qiong;Kan Wusheng(Department of Orthopaedics,Wuhan Fourth Hospital,Wuhan Puai Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430033,China;Department of Orthopaedics,CR&WICO General Hospital,Wuhan 430080,China)

机构地区：[1]武汉市第四医院,华中科技大学同济医学院附属普爱医院骨科,430033 [2]华润武钢总医院骨科,武汉430080

出　　处：《中华创伤骨科杂志》2019年第11期939-944,共6页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨新设计的股骨颈动力加压锁定钉板系统治疗股骨颈骨折的临床疗效。方法回顾性分析2015年2月至2016年10月期间华中科技大学同济医学院附属普爱医院骨科收治的47例股骨颈骨折患者资料。男30例,女17例;年龄(26~68)岁,平均43.5岁。骨折按Pauwels分型:Ⅰ型24例,Ⅱ型16例,Ⅲ型7例。骨折移位程度按照Garden分型标准:Ⅱ型23例,Ⅲ型19例,Ⅳ型5例。所有患者均行骨折闭合或切开复位股骨颈动力加压锁定钉板系统内固定术,其中切开复位3例。术后记录骨折愈合时间、股骨头坏死和股骨颈短缩等情况。末次随访时采用Harris评分评定疗效。结果所有患者均获完整随访,随访时间(22~39)个月,平均29.7个月。所有患者骨折均获得骨性愈合,愈合时间9~15周,平均12.2周。股骨头坏死1例,股骨头坏死率2.1%。股骨颈短缩≤5 mm的6例,股骨颈短缩>5 mm且<10 mm的2例,总颈短缩发生率17.0%。末次随访时Harris评分为77~98分,平均92.2分,其中优42例,良3例,中2例,优良率95.7%。结论新型股骨颈动力加压锁定钉板系统治疗股骨颈骨折疗效优良,值得在临床中推广使用。Objective To evaluate Kangli hollow screws with sliding compression locking plate system(KHS)in the treatment of femoral neck fractures.Methods From February 2015 to October 2016,47 femoral neck fractures were treated at Department of Orthopaedics,Wuhan Fourth Hospital,Wuhan Puai Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology.They were 30 men and 17 women,aged from 26 to 68 years(average,43.5 years).According to the Pauwels classification,there were 24 cases of typeⅠ,16 cases of typeⅡand 7 cases of typeⅢ;according to the Garden classification,there were 23 cases of typeⅡ,19 cases of typeⅢand 5 cases of typeⅣ.All the fractures were immobilized with KHS after closed reduction or open reduction(3 cases).The fracture union time,femoral head necrosis and femoral neck shortening were observed after operation.The Harris scores were used to evaluate therapeutic effects at the final follow-up.Results All the patients were followed up for an average of 29.7 months(from 22 to 39 months).All the fractures obtained solid bony union after 9 to 15 weeks(average,12.2 weeks).Femoral head necrosis occurred in one case(2.1%).Femoral neck shortening≤5 mm was observed in 6 cases and femoral neck shortening>5 mm<10 mm in 2 cases,giving a total shortening rate of 17.0%.The Harris scores at the final follow-up ranged from 77 to 98 points,averaging 92.2 points.There were 42 excellent,3 good and 2 moderate cases,giving an excellent and good rate of 95.7%.Conclusion KHS can lead to excellent therapeutic effects in the treatment of femoral neck fractures.

关 键 词：股骨颈骨折 骨折固定术 内 骨板 治疗效果 

分 类 号：R68[医药卫生—骨科学]