Peterhans M, von Flüe M, Hildell J, Vogt B
Chirurgische Klinik, Kantonsspital Luzern.
Helv Chir Acta. 1991 Feb;57(5):815-9.
The operative treatment of subcapital femoral neck fractures of stages Garden III and IV in the young patient is still a problem. The current methods of osteosynthesis show a high rate of avascular necrosis of the femoral head. We controlled 24 patients with subcapital femoral neck fracture, who were treated with a dynamic hip screw (DHS). The average age of these patients is 55 years. They were examined after 30-89 months from the operation. All patients were assessed regarding clinical and radiological parameters. All of the six patients with femoral neck fractures of stages Garden I and II had no pain, their clinical results were good. In one of these patients we found a partial avascular necrosis of the femoral head. Four out of the 18 patients with femoral neck fractures of stages Garden III and IV had painful complications, 3 of them needed a reoperation. Fourteen patients of the group with femoral neck fractures of stages Garden III and IV had no pain and wer satisfied with the result. But in this group we found 7 patients with partial avascular necrosis of the femoral head. These results are discussed and compared with data published elsewhere.
年轻患者股骨颈Garden III期和IV期头下型骨折的手术治疗仍是一个难题。目前的骨内固定方法显示股骨头缺血性坏死发生率很高。我们对24例股骨颈头下型骨折患者采用动力髋螺钉（DHS）进行治疗。这些患者的平均年龄为55岁。术后30 - 89个月对他们进行了检查。对所有患者的临床和影像学参数进行了评估。所有6例Garden I期和II期股骨颈骨折患者均无疼痛，临床结果良好。其中1例患者发现股骨头部分缺血性坏死。18例Garden III期和IV期股骨颈骨折患者中有4例出现疼痛并发症，其中3例需要再次手术。Garden III期和IV期股骨颈骨折组中有14例患者无疼痛，对结果满意。但在该组中我们发现7例患者股骨头部分缺血性坏死。对这些结果进行了讨论，并与其他地方发表的数据进行了比较。
