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股骨近端基底干骺端转子间骨折的顺行股骨近端髓内钉治疗。

Surgical treatment of basicervical intertrochanteric fractures of the proximal femur with cephalomeduallary hip nails.

机构信息

Department of Orthopaedics, Tongji Hospital of Tongji University, Shanghai, China.

出版信息

Orthop Surg. 2013 May;5(2):124-9. doi: 10.1111/os.12038.

Abstract

OBJECTIVE

To study the outcome of basicervical intertrochanteric fractures of the proximal femur treated with cephalomeduallary hip nails.

METHODS

The clinical outcomes of 32 cases of basicervical intertrochanteric fractures treated with cephalomeduallary hip nails from January 2008 to June 2010 were retrospectively reviewed and the progress of fracture healing and occurrence of complications recorded. The function of the hip joints was evaluated by the Harris social index 2 years postoperatively.

RESULTS

Thirty patients were followed up until fracture union for at least 24 months. Twenty-seven fractures had healed with no loss of position by 12 months postoperatively; the remaining three had mild varus deformity of the hip joint. No patient had evidence of avascular necrosis of the femoral head. No cut out of the helical blade was visible on radiographs. The mean Harris score was 86.5 (75-96) two years postoperatively, 11 patients having excellent scores, 15 good and 4 fair.

CONCLUSION

Closed reduction and proximal femur intramedullary nail fixation for basicervical intertrochanteric fractures provides stable fixation and allows early exercise. It appears to have excellent outcomes in the short and medium term.

摘要

目的

研究股骨颈基底部骨折采用股骨近端髓内钉治疗的效果。

方法

回顾性分析 2008 年 1 月至 2010 年 6 月采用股骨近端髓内钉治疗的 32 例股骨颈基底部骨折患者的临床资料,记录骨折愈合情况及并发症发生情况,术后 2 年采用 Harris 髋关节评分评估髋关节功能。

结果

30 例患者获得随访,随访时间至少 24 个月。术后 12 个月时,27 例骨折愈合,位置无丢失;其余 3 例有轻度髋关节内翻畸形。所有患者均未见股骨头缺血性坏死征象,螺旋刀片无穿出。术后 2 年的 Harris 评分平均为 86.5(75~96)分,其中优 11 例,良 15 例,可 4 例。

结论

股骨颈基底部骨折采用闭合复位、股骨近端髓内钉固定可获得稳定的固定,允许早期活动,短期和中期疗效满意。

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