【摘要】 目的探讨应用中空加压螺丝钉治疗股骨颈骨折的可行性,优点及疗效,并探讨老年股骨颈骨折围手术期治疗的重要性。方法对36例股骨颈骨折中空加压螺丝钉治疗的临床资料进行回顾性分析。其中Garden Ⅰ型4例、Ⅱ型11例,Ⅲ型14例、Ⅳ型7例、60岁以上老年患者多半患有合并1-2种不同程度的内科疾病在术前充分治疗控制后,进行中空加压螺丝钉内固定手术,术后均进行随访。结果本组住院期间无死亡病例,平均随访3.6年。早期并发症7例,发生率为20%。远期并发症4例发生率为11.9%, 其中2例骨不连骨折移位,1例股骨头坏死,其余32例全部愈合,愈合率为91.67%,按马元璋功能评判标准分级凡髋关节屈伸活动恢复超过120°属优,本组23例;屈伸活动恢复90-120°属良,本组10例;屈伸活动小于90°属差3例;优良率:91.67%。结论中空加压螺丝钉治疗股骨颈骨折操作简单, 符合生物力学特点,固定牢固可靠骨折愈合率高,对病人打击小,术后反应轻,可局麻操作,老年人能耐受,尤其要重视老年人合并内科疾患的围手术期治疗可以减少并发症。更多还原

【Abstract】 Objective To discuss the feasibility, advantage and effect of the application of Compressed hollow screws in the treatment of the femoral neck fracture and also to discuss the importance of preoperative management of the femoral neck fracture in aged patients. Methods Thirty six patients of the femoral neck fracture (Garden Ⅰ 4, Garden Ⅱ 11, Garden Ⅲ 14 and Garden Ⅳ 7) with the application of Compressed hollow screws were re-gressively analyzed. The patients in aged patients over 60 had usually 1-2 kinds of medical diseases. After they were completely treated, the operation of the application of Compressed hollow screws was made and then all patients were followed up. Results No death occurred during the operation or hospitalization and the follow-up period averaged 3.6 years. Short-term complications occurred in 7 cases (20%) and long-term ones in 4 cases (11.9%). All other 32 cases (91.67%) healed up well except for one ischemic necrosis of femoral head and 2 non-union of femoral neck fracture. According to Ma Yuanzhang functional evaluation criteria, 23 cases (63.89%) were excellent, 10 (23.87%) were good and 3 (8.33%) were bad. Conclusion The application of Compressed hollow screws in treatment of femoral neck fracture is easy to use because of their biomechanical features and can provide reliable fixation and high healing rate. Also, the operation uses only local anaesthesia and has little injured and few complications to patients and aged patients can be tolerant. Additionally, we should attach importance to preoperative management in aged patients with medical diseases to reduce operative complications.更多还原