手法复位空心钉内固定治疗中老年GardenⅢ、Ⅳ型股骨颈骨折Manual reduction of hollow nail fixation in the elderly Garden Ⅲ, Ⅳ femoral neck fracture.pdfVIP

提 要 目的：探讨手法复位与切开复位治疗中老年GardenⅢ、Ⅳ型股骨颈骨折对术后骨折不 愈合与股骨头坏死的影响。 方法:收集2009-2010年山东中医药大学附属山东省中医院骨科病房行内固定手术治 疗的62例45—60岁GardenIII、Ⅳ型股骨颈骨折患者，随机分配成两组：手法复位组 和切开复位组。术后随访12-18个月，分析骨折不愈合与股骨头坏死发生率、评价术 后患者Harris评分情况。 结果：手法复位组30例患者有2例发生骨折不愈合，骨折不愈合率为6.67﹪, 2例发生 股骨头坏死，股骨头坏死率为6.67﹪。切开复位组32例患者6例发生骨折不愈合18.8 ﹪,4例发生股骨头坏死，股骨头坏死率为12.5﹪。 结论:手法复位组与切开复位组相比使骨折不愈合、股骨头坏死的发生率明显下降； 术后患者髋关节Harris评分明显优于切开复位组。在治疗中老年GardenⅢ、Ⅳ型股骨 颈骨折手法复位优于切开复位。 关键词：股骨颈骨折；手法复位；空心钉内固定. Gimmick reset cannulated screw internal fixation for elderly Ⅲ, Ⅳ Garden type femoral neck fracture Specialty：Orthopaedics of TCM Author ：Wang Xin Tutor：Wang Mingxi Abstract Objective: Explore treatment middle-aged GardenⅢ Ⅳtechnique of femoral neck fracture reset and open reduction of postoperative fracture healing and avascular necrosis of the influence Methods: we collected 2009-2010 in shandong province of shandong university of traditional Chinese medicine hospital affiliated industry fixed surgery orthopedic ward of 62 cases GardenIII, 45-60 years old Ⅳ type femoral neck fracture patients, randomly assigned into two groups: Gimmick reset group and open reduction group. Follow-up of 12 to 18 months, analysis fracture healing and avascular necrosis of the incidence, evaluation postoperative patients ratings Harris. Results: Gimmick reset group of 30 patients had 2 cases of fracture nonunion, fracture healing rate for 6.67 ﹪, two case occurred avascular necrosis of the femoral head for the necrosis rate, 6.67 ﹪. Open reduction group of 32 patients fracture nonunion in 6cases, 4 cases had 18.8 ﹪, avascular necrosis of the femoral head for the necrosis rate of 12.5 ﹪. Conclusion: Gimmick reset group group compared with open re