Kapoor Amit, Deety Lakshmi Venkatesh, John Vinith Zachariah, Devadoss Sathish, Devadoss A
Institute of Orthopedic Research and Accident Surgery, Madurai, India.
Int J Low Extrem Wounds. 2012 Mar;11(1):49-58. doi: 10.1177/1534734612438056. Epub 2012 Feb 14.
This study describes a 2- to 13-year follow-up of a novel technique for osteosynthesis of neglected femoral neck fractures and nonunions that combines internal fixation with the benefits of fibular grafting and valgus angulation osteotomy. Twenty-three patients were treated by the "3-in-1" surgery, which consisted of osteosynthesis with a dynamic hip screw, nonvascularized fibular grafting, and valgus osteotomy, between January 1996 and June 2009. Union was achieved in all patients at an average of 5.4 months. The average shortening was 0.9 cm. Although avascular necrosis was seen in 4 patients, 2 of them still had good functional scores. Excellent and good hip functional scores were seen in 18 patients. Well-executed surgeries combining biomechanics and biology can ensure union in neglected femoral neck fractures and nonunions provided an adequate length of the neck and proximal fragment is present and there is no subchondral collapse.
本研究描述了一种用于治疗被忽视的股骨颈骨折和骨不连的新型骨合成技术的2至13年随访情况，该技术将内固定与腓骨移植和外翻成角截骨的益处相结合。1996年1月至2009年6月期间，23例患者接受了“三合一”手术治疗，该手术包括使用动力髋螺钉进行骨合成、非血管化腓骨移植和外翻截骨。所有患者均在平均5.4个月时实现骨愈合。平均缩短0.9厘米。虽然4例患者出现了缺血性坏死，但其中2例仍具有良好的功能评分。18例患者的髋关节功能评分优良。如果股骨颈和近端骨折块有足够长度且无软骨下塌陷，精心实施的结合生物力学和生物学的手术可确保被忽视的股骨颈骨折和骨不连实现骨愈合。
