空心钉加血管蒂骨瓣治疗青壮年股骨颈骨折.DOCVIP

临床医学论文-空心钉加血管蒂骨瓣治疗青壮年股骨颈骨折 【摘要】? 目的 探讨空心钉加带双血管蒂大转子骨瓣移植治疗股骨颈骨折的临床效果。方法 自2002年7月至2005年7月，采用空心钉加带双血管蒂大转子骨瓣移植治疗青壮年股骨颈骨折35 例，术后6～8个月开始部分负重，术后11个月开始完全负重。结果 35 例随访15～52个月，平均25个月。33 例骨折愈合，愈合时间7～11个月，平均8.2个月。Harris髋关节功能评分平均为92.6分。随访期间2 例发生股骨头坏死，其中1 例改行人工全髋关节置换，另1 例行康复治疗。结论 该手术方法疗效满意，是青壮年股骨颈骨折的一种有效治疗方法。 【关键词】? 股骨颈骨折；空心钉；大转子；骨瓣；外科手术 ??? Treatment of Femoral Neck Fractures in Young and Middleaged Patients by Using Hollow Screw Fixation and Greater Trochanteric Bone Flap Pedicled with Double Blood Vessels ???? Abstract： Objective? To evaluated the clinical results of treatment of femoral neck fractures in young and middleaged patients by using hollow screw fixation and greater trochanteric bone flap pedicled with double blood vessels. Methods? Thirtyfive femoral neck fractures were treated by using hollow screw fixation and greater trochanteric bone flap pedicled with double blood vessels from July 2002 to July 2005. Partial weight beating started on 6 to 8 months postoperatively and full weight beating on 11 months postoperatively. Results? The mean duration of follow up was twentyfive months (range from 15 to 52 months) in all cases. Fracture healed successfully in 33 cases. The average time of fracture healing was 8.2 months (range from 7 to 11 months). Harris hip joint function score was average 92.6. Two femoral head necroses were noted during the followup period. One of them was treated with total hip replacement postoperatively， another underwent the rehabilitative training. Conclusion? This method has satisfactory results， and it′s an effective method for the treatment of femoral neck fractures in young and middleaged patients. ??? Key words： femoral neck fracture； hollow screw； greater trochanter； bone flap； surgical operation ??? 股骨颈骨折的治疗中存在骨折不愈合和股骨头缺血坏死等并发症，是创伤骨科领域中研究的焦点之一。自2002年7月至2005年7月，我院采用空心加压螺纹钉内固定加带双血管蒂大转子骨瓣移植治疗青壮年股骨颈骨折35 例，取得满意疗效，现报告如下。 ??? 1? 临床资料 ??? 1.1? 一般资料? 本组35 例，男20 例，女15 例；年龄20～54 岁，平均36 岁；左侧骨折21 例，右侧骨折14 例。骨折分型：GardenⅠ型5 例，Ⅱ型9 例，Ⅲ型15 例，Ⅳ型6 例。新