摘要
目的探讨应用股骨头、干三维互动复位技术治疗难复位性股骨颈骨折的效果。方法选择2011年6月-2013年7月收治的40例难复位性股骨颈骨折患者（研究组），术中应用股骨头、干三维互动技术进行骨折闭合复位，用3枚空心螺钉固定。术后摄股骨颈正、侧位X线片，根据Garden指数评估股骨颈骨折复位质量，根据髋关节Harris评分标准评估患髋功能恢复情况。同时回顾性分析2008年1月_2010年12月采用切开复位空心钉内固定治疗的32例难复性股骨颈骨折患者作为对照组。术后根据Harris评分评估患髋功能恢复情况。结果研究组应用微创闭合技术复位满意。根据Garden指数评估，24例骨折复位质量为1级，16例为2级。32例患者获得平均21个月（12～28个月）随访，骨折均愈合，末次随访时患髋Harris评分为87分（61～100分），4例发生股骨头缺血性坏死。对照组6例骨折未愈合，末次随访时患髋Harris评分为60分（20～100分），8例发生股骨头缺血性坏死。结论与传统切开复位技术相比，应用股骨头、干三维互动闭合复位技术可更好地治疗难复位性股骨颈骨折，患侧髋关节功能恢复良好，并可有效降低股骨头缺血性坏死、骨折不愈合发生率。
Objective To investigate the therapeutic effect of three-dimensional interactive reduction of femoral neck and shaft in treatment of irreducible femoral neck fracture. Methods The study enrolled 40 patients with irreducible femoral neck fractures treated by three-dimensional interactive reduction of femoral neck/shaft and internal fixation with three cannnlated screws from June 2011 to July 2013 （ study group）. Frontal and lateral X-ray films were taken after operation. Garden index was used to evaluate the fracture reduction quality and Harris hip score was recorded. Meanwhile, a retrospective analysis was performed on 32 patients with irreducible femoral neck fractures treated by open reduction and internal fixation with cannulated screws between January 2008 and December 2010 （control group）. Results Patients in study group obtained satisfactory reduction by minimally traumatic closed reduction. According to the Garden index, fracture reduction quality was level 1 in 24 patients and level 2 in 16 patients. Thirty-two patients were followed up for 12-28 months （mean, 21 months）, which showed fracture healing. At the final follow-up, Harris hip score was 87 points （range, 61-100 points） and 4 patients had femoral head avascular necrosis. By contrast, 6 patients in control group showed frac- ture nonunion. At the final follow-up, Harris hip score was 60 points （range, 20-100 points） and 8 pa- tients had femoral head avascular necrosis. Conclusion Three-dimensional interactive reduction of femoral neck and shaft provides good hip function recovery and decreased incidence of femoral head avas- cular necrosis and fracture disunion compared with the open reduction and internal fixation.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2014年第3期217-220,共4页
Chinese Journal of Trauma
关键词
股骨骨折
股骨颈
外科手术
微创性
股骨头干三维互动技术
Femoral fractures
Femur neck
Surgical procedures, minimally invasive
Three-dimensional interactive reduction technique
