直接前侧入路切开复位空心加压钉固定治疗儿童股骨颈骨折  

Direct anterior approach open reduction and cannulated compression screw fixation for treatment of femoral neck fractures in children

作　　者：禇祥军 马海龙 谢康 李阳[1] 袁毅[1] 孙军[1] CHU Xiang-jun;MA Hai-long;XIE Kang;LI Yang;YUAN Yi;SUN Jun(Dept of Orthopaedics,Province Children′s Hospital of Anhui Medical University,Hefei,Anhui 230051,China)

机构地区：[1]安徽医科大学附属省儿童医院骨科,安徽合肥230051

出　　处：《临床骨科杂志》2022年第3期408-411,共4页Journal of Clinical Orthopaedics

基　　金：国家自然科学基金(编号:U19A2057)。

摘　　要：目的探讨直接前侧入路切开复位空心加压钉固定治疗儿童股骨颈骨折的疗效。方法采用直接前侧入路切开复位空心加压钉固定治疗27例移位的股骨颈骨折闭合复位失败患儿。记录骨折复位质量、骨折愈合情况、并发症发生情况。采用Ratliff评分标准评价术后髋关节功能。结果患儿均获得随访,时间3~5年。骨折复位质量:优20例,良5例,可2例。骨折均愈合,时间6~10个月。4例股骨头坏死,1例股骨头骺早闭,无髋内翻发生。末次随访时采用Ratliff评分标准评价术后髋关节功能:优23例,良2例,可1例,差1例,优良率25/27。结论直接前侧入路切开复位空心加压钉固定治疗儿童股骨颈骨折,具有创伤小、复位质量高、股骨头坏死发生率低的优点,可使患儿获得良好的髋关节功能。Objective To investigate the effect of direct anterior approach(DAA)open reduction and cannulated compression screw fixation for treatment of femoral neck fractures in children.Methods The 27 children who were suffered from displaced femoral neck fractures with closed reduction failure were treated by open reduction and cannulated compression screw fixation via DAA.The quality of fracture reduction,fracture healing conditions and complications were recorded.The Ratliff score standard was used to evaluate the postoperative hip function.Results All patients were followed up for 3~5 years.The quality of fracture reduction was excellent in 20 cases,good in 5,fair in 2.All fractures healed within 6~10 months.There were 4 cases of femoral head necrosis,1 case of femoral head epiphysis early closure,no coxa varus occurred.At the last follow-up,Ratliff score standard for evaluation of postoperative hip function:excellent in 23 cases,good in 2,fair in 1 and poor in 1,with an excellent and good rate of 25/27.Conclusions For the treatment of femoral neck fractures in children,DAA open reduction and cannulated compression screw fixation have advantages of less trauma,high quality of reduction and low incidence rate of femoral head necrosis.

关 键 词：股骨颈骨折 切开复位 直接前侧入路 儿童 

分 类 号：R726.834.2[医药卫生—儿科] R726.873[医药卫生—临床医学]