【摘要】 目的探讨空心螺钉内固定治疗青壮年新鲜股骨颈骨折的临床疗效。方法采用空心螺钉内固定治疗38例青壮年新鲜股骨颈骨折患者。记录手术情况,采用Harris评分评价髋关节功能恢复情况。结果患者均获得随访,时间13～36个月。29例术后3～6个月骨折愈合; 4例骨折延迟愈合,经减少活动后术后6～9个月愈合; 5例发生骨不连,2例采用人工髋关节置换术治疗,3例未做特殊治疗。末次随访时,采用Harris评分评价髋关节功能:优16例,良11例,可6例,差5例,优良率为71.05%(27/38)。末次随访时,髋关节功能优良率骨折PauwelsⅠ、Ⅱ型患者优于Ⅲ型患者,差异有统计学意义(P <0.05);伤后8 h内急诊手术的患者与伤后至手术时间3～15 d的患者比较差异无统计学意义(P> 0.05)。结论空心螺钉内固定治疗青壮年新鲜股骨颈骨折具有创伤小、恢复快、疗效确切的优点,但需把握好手术适应证以及手术时机。对于移位严重、极不稳定的股骨颈骨折,空心螺钉内固定方式还需改进治疗方法及完善手术技巧。更多还原

【Abstract】 Objective To investigate the clinical effect of cannulated screw internal fixation for treatment of fresh femoral neck fracture in young adults. Methods Thirty-eight young adults patients with fresh femoral neck fractures were treated with cannulated screw internal fixation. The operation situation was recorded. The Harris score was used to evaluate the postoperative hip function recovery. Results All patients were followed up for 13 ～ 36 months,29 cases healed within 3 ～ 6 months after operation; 4 cases were delayed healing,and healed in 6 ～ 9 months after reducing activity. Five patients had nonunion,of wich 2 cases underwent artificail hip replacement,and 3 cases did not do special treatment. At the last follow-up,the results of hip function assessed with Harris scoring system: 16 cases were excellent,11 cases good,6 fair and 5 poor,with the excellent-good rate of 71. 05%( 27/38). At the last follow-up,for excellent-good rate of hip function,the patients with Pauwels type Ⅰ,Ⅱ were better than Pauwels type Ⅲ,with the statistical differences( P < 0. 05),and there was no difference in patients between less than 8 h after trauma and 3 ～ 15 d duration from trauma to operation( P > 0. 05). Conclusions The cannulated screw internal fixation has the advantages of less trauma,fast recovery,exact curative effect in the treatment of fresh femoral neck fracture in young adults,but the surgery indications and timing of operation should be well controlled. For the severely displaced and unstable femoral neck fracture,the cannulated screw internal fixation method still needs to improve the treatment methods and surgical techniques.更多还原