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股方肌肌蒂骨瓣加螺丝钉固定治疗青壮年股骨颈骨折的远期疗效研究

[Study on the long-term effects of the quadratus femoris muscle pedicle bone graft with screw fixation for the treatment of femoral neck fractures in young adults].

作者信息

Yun Xiang-Dong, Xia Ya-Yi, Wan Lin, Wang Jing, Han Hua, Zhang Cheng-Jun

机构信息

Department of Orthopaedics, Second Affiliated Hospital of Lanzhou University, Lanzhou 730030, Gansu, China.

出版信息

Zhongguo Gu Shang. 2010 Mar;23(3):164-6.

Abstract

OBJECTIVE

To analyze the long-term effects of the quadratus femoris muscle pedicle bone graft with screw fixation for the treatment of femoral neck fractures in young adults.

METHODS

From 2002 to 2008, 38 patients with femoral neck fractures were operated. There were 22 males and 16 females, with an average age of 40 years (ranged 25 to 60 years). Twenty-six patients injured from high velocity road traffic accident, among which 14 patients injured in automobile accident, 8 in two wheeler accident and 4 in fall from height. Twelve patients had serious associated injuries. Femoral neck fractures were classified by Garden classification: 25 patients were Graden II and 13 patients were Graden III. Thirty-six patients underwent emergency operation and 2 had delayed operation. Clinical scores were evaluated based on Sanders scores and the radiological criteria which was judged by the diminution of density in the necrotic portion of the femoral head.

RESULTS

All the patients were followed up for at least 2 years (ranged 2 to 5 years). There were significant differences between preoperation and postoperation in pain, function, muscle power and walk ability. All the patients with fractures were healed in an average of 5 months after operation and walked without aids and no complications occurred.

CONCLUSION

This technique provides a high union rate with a low complication rate. In addition, the surgical procedure is relatively simple and has a nice long-term result.

摘要

目的

分析采用股方肌蒂骨瓣加螺丝钉固定治疗青壮年股骨颈骨折的远期疗效。

方法

2002年至2008年,对38例股骨颈骨折患者行手术治疗。其中男性22例,女性16例,平均年龄40岁(25至60岁)。26例患者因高速道路交通伤致伤,其中14例为汽车事故伤,8例为两轮车事故伤,4例为高处坠落伤。12例患者伴有严重合并伤。股骨颈骨折按Garden分型:GardenⅡ型25例,GardenⅢ型13例。36例患者行急诊手术,2例患者行延期手术。根据Sanders评分及股骨头坏死区密度减低的影像学标准进行临床评分。

结果

所有患者均随访至少2年(2至5年)。术前与术后在疼痛、功能、肌力及行走能力方面存在显著差异。所有骨折患者术后平均5个月骨折愈合,可独立行走,无并发症发生。

结论

该技术骨折愈合率高,并发症发生率低。此外,手术操作相对简单,远期效果良好。

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