空心加压螺钉内固定带缝匠肌髂骨瓣移植治疗股骨颈骨折.docVIP

精品论文 参考文献 空心加压螺钉内固定带缝匠肌髂骨瓣移植治疗股骨颈骨折 零勇胜 （江苏省宜兴市红塔医院骨科 214201） 【摘要】目的 探讨空心加压螺钉内固定配合带缝匠肌的髂骨瓣移植治疗股骨颈骨折的治疗效果。方法 对12例股骨颈骨折患者采用空心加压螺钉内固定，并在骨折断端用带缝匠肌的髂骨瓣植骨固定。结果 随访14～36月,12例中11例达骨性愈合，1例术后7月出现股骨头坏死行髋关节置换。平均愈合时间8个月,平均取钉时间13个月。根据功能恢复情况分为优、良、差,进行疗效评定:优8例,良3例,差1例。优良率达91.6%。结论 空心加压螺钉内固定加带缝匠肌的髂骨瓣移植治疗股骨颈骨折,具有固定牢靠、愈合率高等优点。 【关键词】股骨颈骨折 空心加压螺钉内固定术 带缝匠肌髂骨瓣 植骨术 【中图分类号】R687 【文献标识码】A 【文章编号】2095-1752（2013）22-0126-02 【Abstract】Objective]To discuss the curative effect of using the Compression Screw Immobilization and the sartorial-pedicled ilium bone graft in treating the fracture of neck of femur.[Method]A total of 12 cases of the fracture of neck of femur treated with the Compression Screw Immobilization and the sartorial-pedicled ilium bone graft were followed up for 14～36 months.The position of fracture or the area of bony defect was filled with the sartorial-pedicled ilium bone.[Result]The clinical results were assessed according to the functional rehabilitation.So,there were excellent results of 8 hips,good of 3 hips and poor of 1 hips in this study and the satisfactory rate was 91.6%.There were 12 cases reached osteal healing.The average healing time was 8 months and the average time of taken out was 13 months.[Conclusion]In treating the fracture of neck of femur,the Compression Screw Immobilization and the sartorial-pedicled ilium bone graft have the advantage of firm fixation and highly healing rate. 【Keyword】The fracture of neck of femur Compression Screw Immobilization The sartorial-pedicled ilium bone bone grafting 股骨颈骨折由于功能解剖上的特点，骨折部位常承受较大的剪应力，影响骨折复位或复位后的稳定性。而且股骨头血供的特殊性，骨折时易使主要供血来源阻断，不但影响骨折愈合，且有可能发生股骨头缺血坏死及塌陷的不良后果，发生率约20％～40％。自2007年6月～2010年6月,我科采用空心加压螺钉内固定加带缝匠肌的髂骨瓣移植的方法治疗股骨颈骨折12例,对其关节功能、X线片表现等情况进行随访,均收到了满意的效果，现报道如下： 1 材料与方法 1.1 病例资料 本组12例其中男9例,女3例;年龄36～65岁,平均49岁;骨折分类按Gar-den分类:Ⅰ型1例,Ⅱ型4例,Ⅲ型5例,Ⅳ型2例。伤后2h～4d入院，伤后至手术时间4h～7d。固定材料选用国产的空心加压螺钉,钉长从80～100 mm不等。 1.2 术前准备