【作者】 王旭；

【导师】 谷长跃；

【作者基本信息】 吉林大学 ， 外科学， 2006， 硕士

【摘要】 目的:评价股骨头骨折的治疗方法并分析其结果。方法:对我院1996年1月~2006年1月共52例股骨头骨折患者进行随访,最后获得书信和电话资料39例,采用Pipkin分类方法,根据刘氏参照美国矫形外科研究院估价髋关节功能的方法并对随访结果进行分析。结果:术后X线检查证实骨折复位良好,股骨头置换者假体位置良好。随访6～124个月,根据刘氏参照美国矫形外科研究院估价髋关节功能的方法并对随访结果进行分析,优12例,良21例,可3例,差3例,优良率84.6%。结论:对于合并髋关节脱位的病例应尽早手法复位,骨折块位置满意行皮牵引约6—8周;复位不满意或不伴有髋关节脱位的病例,应手术切开复位。Ⅰ型骨折复位固定较为困难,可切除小的骨折片,大的骨折片予以固定;Ⅱ型骨折应解剖复位,坚强内固定;Ⅲ型损伤应早期切开复位,行螺丝钉内固定术,或行人工关节置换;对于Ⅳ型骨折,全髋关节置换术是一个好的治疗方法,也可将髋臼与股骨头骨折处分别固定。此类骨折属于关节内骨折,无论何型均应尽早进行功能锻炼。更多还原

【Abstract】 Objective: The fracture of femoral head is uncommonclinically,and we can see six to sixteen cases in one–hundredcases of posterior dislocation of the hip in literature . In recentyears ,the risk of the fracture is higher and higher with thedevelopment of communication and iudustry. The femoral head liesdeeply, and it’s main blood supply comes from femoral neck ,sowhen the femoral head is broken and it’s blood supply is disturbedwe can see femoral head necrosis . The objective is to explore theeffective ways of treating of the different type fracture of thefemoral head to get satisfied prognosis and make the function ofjoints get the best state. Methods: Review the 39 cases of the fracture of the femoralhead that are cured in our hospital in 1996—2006. Of the 39cases ,33 are male and 6 are female.The age is 19—56 years old,and the average is 36.3 years old. Of the 39 cases , 6 cases are oldand many have complications . The hip dislocation is 25 cases,thefracture of acetabulum is 10 cases, the sciatic nerve injury is 4cases. Classification is based on Pipkin’s criteria . Of the 39 cases ,15 are type Ⅰ, 12 are type Ⅱ,2 are type Ⅲ,10 are typeⅣ.Various procedures were taken according to classification andpathology.Result: Follow–up study is 6 months～124 months ,and theaverage is 56.5 months.According to the criteria of Liu xi,we studythe function of the hip joint of the 39 cases , and find that of the 39cases ,excellent results are achieved in 12 cases, good in 21, fairin 3, poor in 3.Rate of excellent and good result is 84.6﹪.Conclusion: Manu replacement should be taken as quickly aspossible for the cases with dislocation of hip joint, then when thereplacement is satisfied we can make skin traction for 6—8 weeks,but when the replacement is not satisfied or for the cases that arenot with dislocation of the hip joint,we have to operate.Thereplacement and fixation is difficult for the Ⅰtype fracture, andthe excision of the small fragement is a good choice of treatment.Type Ⅱ fractures should be operate at with stable interalfixation .Type Ⅲ can be treated with stable interal fixation or totalhip replacement. Type Ⅳ should be treated with total hipreplacement or fix the femoral head and acetabulum respectively.更多还原