【作者】 高书图； 刘又文； 陈献韬； 张晓东； 李建明； 陈柯； 段卫峰；

【机构】 河南省洛阳正骨医院；

【摘要】 目的探讨治疗青壮年股骨颈陈旧性骨折的有效方法。方法自1998年3月～2008年3月应用带缝匠肌蒂髂骨骨瓣和旋股外侧血管束植入或同时游离髂骨骨板重建股骨颈,联合多钉内固定、中药治疗青壮年股骨颈陈旧性骨折。临床应用87例,其中有完整随访资料的64例,男性49例,女性15例。年龄最小者16岁,最大者56岁,平均年龄33.1岁。受伤至此次手术时间为34天～24个月,平均8.7个月。Garden骨折分型:Ⅲ型25例,Ⅳ型39例。结果64例随访12～96个月,平均37个月。全部病例中62例骨折愈合,临床愈合时间3～10个月,平均7.5个月。2例因术后过早下地负重,内固定物松动,最终行关节置换手术。依据Harris评分标准,最后一次随访时对所有病例进行疗效评价,平均85.2分。结论带缝匠肌蒂髂骨骨瓣和旋股外侧血管束植入或同时游离,骨骨板重建股骨颈,联合多钉内固定、中药可明显改善折端血运,是治疗青壮年股骨颈陈旧性骨折的较为理想的方法。更多还原

【Abstract】 Objective To investigate an effective method for obsolete femoral neck fractures in young patients.Methods Eighty-seven obsolete femoral neck fracture were treated by open reduction,internal fixation with multiple nails,bone graft with iliac flap pedicled with sartorius muscle and vascular bunch inserting of lateral circumflex femoral artery,necessary reconstructing femoral neck with iliac bone plate and postoperative traditional Chinese medicine from March 1998 to June 2006.Complete data were available in 64 cases(49 males and 15 females).The patients’ age ranged from 16 to 56 years old with the average of 33.1 years old. The average duration from injury was 8.7 months(range from 34 days to 24 months).There were 25 cases in Garden typeⅢand 39 cases in Garden typeⅣ.Results The mean duration of follow-up was thirty-seven months(range from 12 to 96 months).Fracture healed successfully in 62 cases of 64 cases.The average time of fracture healing was 7.5 months(range from 3 to 10 months).Two cases with screws losing were treated with total hip arthroplasty because of too early mobilization. All the cases were evaluated at the last follow-up and the score was an average of 85.2 according to Harris score system.Conclusions The combination of open reduction,internal fixation with multiple nails,bone graft with iliac flap pedicled with sartorius muscle and vascular bunch inserting of lateral circumflex femoral artery,necessary reconstructing femoral neck with iliac bone plate and postoperative traditional Chinese medicine is an ideal procedure for obsolete femoral neck fracture.更多还原