Department of Orthopaedics, Thriasio General Hospital, Elefsina, Greece.
Injury. 2009 Mar;40(3):277-9. doi: 10.1016/j.injury.2008.07.024. Epub 2009 Feb 25.
It is widely thought that the posterior retinaculum is intact only in relatively undisplaced intracapsular fractures, and interruption of the arterial flow through the retinacular arteries to the femoral head is the main cause of avascular necrosis after fracture of the neck.
In order to test the hypothesis that the posterior retinaculum is torn after a displaced femoral neck fracture, 112 patients (45 males and 67 females), 75 years old on average, underwent a hemiarthroplasty for a displaced femoral neck fracture. There were 71 Garden type III and 41 Garden type IV fractures. The integrity of the posterior retinaculum was examined intraoperatively in every patient during the procedure.
The posterior retinaculum was found intact in all of the Garden type III fractures and in 39 Garden type IV fractures. The posterior retinaculum was found torn in two Garden type IV fractures. There was no tearing in any other part of the capsule of the hip joint in any patient.
The posterior retinaculum of the hip joint remains intact after a displaced femoral neck fracture in all of Garden type III fractures and in the great majority of Garden type IV fractures.
人们普遍认为，后关节囊只有在相对无移位的囊内骨折中才完整，而通过关节囊动脉到股骨头的动脉血流中断是颈骨折后发生缺血性坏死的主要原因。
为了验证后关节囊在移位股骨颈骨折后撕裂的假设，我们对 112 名患者（45 名男性和 67 名女性）进行了研究，这些患者平均年龄为 75 岁，均因移位股骨颈骨折接受了半髋关节置换术。其中 71 例为 Garden Ⅲ型，41 例为 Garden Ⅳ型骨折。在每位患者的手术过程中，我们都对后关节囊的完整性进行了术中检查。
所有 Garden Ⅲ型骨折和 39 例 Garden Ⅳ型骨折的后关节囊均完整。有两例 Garden Ⅳ型骨折的后关节囊撕裂。在任何患者中，髋关节囊的其他任何部位均未出现撕裂。
在后关节囊完整的情况下，所有 Garden Ⅲ型骨折和大多数 Garden Ⅳ型骨折中，髋关节的后关节囊在移位股骨颈骨折后仍保持完整。
