摘要
目的比较单纯闭合复位、闭合复位后择期骨块切除以及急诊切开骨块切除复位3种方法治疗PipkinⅠ型股骨头骨折伴髋关节后脱位的疗效。方法 2002年1月-2008年1月,收治24例PipkinⅠ型股骨头骨折伴髋关节后脱位患者,分别采用单纯闭合复位8例(闭合复位组)、闭合复位后择期采用Smith-Petersen入路骨块切除8例(择期手术组)、急诊Smith-Petersen入路骨块切除复位8例(急诊手术组)治疗。闭合复位组:男6例,女2例;年龄19～56岁,平均37.6岁。交通事故伤6例,高处坠落伤1例,重物压伤1例。受伤至入院时间1.0～7.5 h,平均3.1 h。受伤至成功复位时间为(4.00±2.14)h。择期手术组:男7例,女1例;年龄21～59岁,平均37.3岁。交通事故伤7例,高处坠落伤1例。受伤至入院时间1.0～6.0 h,平均3.2 h。受伤至成功复位时间为(3.90±1.47)h。急诊手术组:男5例,女3例;年龄20～58岁,平均35.5岁。交通事故伤5例,高处坠落伤1例,重物压伤2例。受伤至入院时间1.5～6.5 h,平均3.3 h。受伤至成功复位时间为(5.10±2.04)h。3组患者性别、年龄、病程、受伤至成功复位时间等一般资料比较,差异均无统计学意义(P>0.05),具有可比性。结果择期手术组及急诊手术组患者术后切口均Ⅰ期愈合。3组患者均获随访,随访时间24～58个月,平均38.7个月。术后24个月按Thompson-Epstein评分标准进行功能评定,闭合复位组优良率为50.0%(4/8),择期手术组为87.5%(7/8),急诊手术组为87.5%(7/8),3组优良率比较差异有统计学意义(χ2=9.803,P=0.020)。术后24个月,闭合复位组1例发生异位骨化(12.5%),择期手术组4例(50.0%),急诊手术组4例(50.0%);闭合复位组发生股骨头缺血性坏死2例(25.0%),其余两组均未见;3组间各种并发症发生率比较差异均无统计学意义(P>0.05)。结论采用Smith-Petersen入路择期与急诊行骨块切除治疗PipkinⅠ型股骨头骨折伴髋关节后脱位的疗效优于单纯闭合复位;�
Objective To evaluate and compare the outcomes of simple closed reduction,selective fragment excision after closed reduction,and emergency fragment excision and reduction in the treatment of Pipkin type I fracture of femoral head associated with posterior dislocation of the hip.Methods Between January 2002 and January 2008,24 patients with Pipkin type I fracture of the femoral head associated with posterior dislocation of the hip were treated with simple closed reduction （closed reduction group,n=8）,with selective fragment excision after closed reduction （selective operation group,n=8）,and with emergency fragment excision and reduction （emergency operation group,n=8）.In the closed reduction group,there were 6 males and 2 females with an average age of 37.6 years （range,19-56 years）; injuries were caused by traffic accident in 6 cases,by falling from height in 1 case,and by crushing in 1 case with a mean disease duration of 3.1 hours （range,1.0-7.5 hours）; and the interval from injury to reduction was （4.00±2.14） hours.In the selective operation group,there were 7 males and 1 female with an average age of 37.3 years （range,21-59 years）; injuries were caused by traffic accident in 7 cases and by falling from height in 1 case with a mean disease duration of 3.2 hours （range,1.0-6.0 hours）; and the interval from injury to reduction was （3.90±1.47） hours.In the emergency operation group,there were 5 males and 3 females with an average age of 35.5 years （range,20-58 years）;injuries were caused by traffic accident in 5 cases,by falling from height in 1 case,and by crushing in 2 cases with a mean disease duration of 3.3 hours （range,1.5-6.5 hours）; and the interval from injury to open reduction was （5.10±2.04） hours.There was no significant difference in the age,gender,disease duration,and interval from injury to reduction among 3 groups （P0.05）.Results All wounds in selective operation group and emergency operation group healed primarily.All the patients were follow
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2011年第5期521-525,共5页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
PIPKIN
Ⅰ型股骨头骨折
髋关节后脱位
闭合复位
择期手术
急诊手术
对比研究
Pipkin type I fracture of femoral head Posterior dislocation of the hip Closed reduction Selective operation Emergency operation Comparative study
