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带肌蒂骨移植在青年成人陈旧性和未愈合股骨颈骨折切开复位内固定治疗中的辅助作用:17例前瞻性研究

Role of muscle pedicle bone graft as an adjunct to open reduction and internal fixation in the management of neglected and ununited femoral neck fracture in young adults: a prospective study of 17 cases.

作者信息

Nair Naveen, Patro D K, Babu Thirunavukkarasu Arun

机构信息

Indira Gandhi Medical College and Research Institute (IGMC&RI), Pondicherry, 605010, India,

出版信息

Eur J Orthop Surg Traumatol. 2014 Oct;24(7):1185-91. doi: 10.1007/s00590-013-1384-x. Epub 2013 Dec 8.

Abstract

AIM

To evaluate the role of quadratus femoris muscle pedicle bone grafting along with open reduction and internal fixation in the treatment of neglected and ununited femoral neck fractures in young adults.

MATERIALS AND METHODS

Young adults within the age group of 15-45 years with ununited, old neglected fractures of femoral neck were included in the study. All patients underwent quadratus femoris muscle pedicle bone grafting along with open reduction and internal fixation. The post-operative complications and functional recovery was assessed using Charnley's modification of Merle D'Aubigne and Postel hip scoring.

RESULTS

A total of 17 patients were included in the study. The average time of union following the procedure was found to be approximately 8 months. There were two cases of delayed union and no cases of avascular necrosis. Ten patients (58.8%) had excellent or very good post-operative functional results and 6 patients (35.3%) had good or satisfactory results.

CONCLUSION

Muscle pedicle bone grafting is a useful adjunct to open reduction and internal fixation for ununited femoral neck fractures. It achieves good final functional results comparable with other methods, but requires greater expertise.

摘要

目的

评估股方肌蒂骨移植联合切开复位内固定术在治疗青年成人陈旧性、未愈合股骨颈骨折中的作用。

材料与方法

本研究纳入年龄在15 - 45岁之间的青年成人,其股骨颈骨折为陈旧性、未愈合且被忽视的骨折。所有患者均接受股方肌蒂骨移植联合切开复位内固定术。采用Charnley对Merle D'Aubigne和Postel髋关节评分的改良方法评估术后并发症及功能恢复情况。

结果

本研究共纳入17例患者。术后平均愈合时间约为8个月。有2例延迟愈合,无缺血性坏死病例。10例患者(58.8%)术后功能结果为优或良,6例患者(35.3%)为良好或满意。

结论

肌蒂骨移植是治疗未愈合股骨颈骨折切开复位内固定术的一种有用辅助方法。它能取得与其他方法相当的良好最终功能结果,但需要更高的专业技术。

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