Sträuli C, Seekamp A, Lehmann U, Bosch U
Chirurgische Klinik, Kantonsspital Schaffhausen, Schweiz.
Swiss Surg. 2001;7(4):167-72. doi: 10.1024/1023-9332.7.4.167.
This study evaluated the complication rate and surgical outcome following cannulated screw fixation of femoral neck fractures in elderly patients. Between 1.6.97 and 31.12.98 we operated on 110 patients with 112 fractures. The mean age was 78.4 years (range 25-96 years). Mean follow up was 6.8 months (range 3-16 months). The mortality rate was 22.7% (25/110). 60 patients with 61 fractures could be evaluated for complications, reoperations, pain and walking ability. 68.9% of the fractures healed. Avascular necrosis developed in 18%. Non-union rate was 8.2% and redislocation rate 4.9%. 18 patients needed a second operation, two thirds received an arthroplasty and one third had implant removal or replacement. In 81.6% of the patients (the patients with secondary arthroplasty excluded) pain relief was good. Insufficient reduction and malposition of the screws are the most common causes for failure of cannulated screw fixation of femoral neck fractures in the elderly.
本研究评估了老年患者股骨颈骨折空心螺钉固定术后的并发症发生率及手术效果。在1997年6月1日至1998年12月31日期间，我们对110例患者的112处骨折进行了手术。平均年龄为78.4岁（范围25 - 96岁）。平均随访时间为6.8个月（范围3 - 16个月）。死亡率为22.7%（25/110）。60例患者的61处骨折可就并发症、再次手术、疼痛及行走能力进行评估。68.9%的骨折愈合。缺血性坏死发生率为18%。不愈合率为8.2%，再脱位率为4.9%。18例患者需要二次手术，其中三分之二接受了关节成形术，三分之一进行了内固定物取出或置换。在81.6%的患者中（排除接受二期关节成形术的患者）疼痛缓解良好。复位不充分及螺钉位置不良是老年患者股骨颈骨折空心螺钉固定失败的最常见原因。
