Lin Zhen-En, Zheng Hong, Chen Xue-Sheng, Li Zhao-Hui
Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou 350007, Fujian, China;
Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou 350007, Fujian, China.
Zhongguo Gu Shang. 2018 Feb 25;31(2):115-119. doi: 10.3969/j.issn.1003-0034.2018.02.004.
To analysis the outcome of modified closure bone setting manipulation for the treatment of femoral neck fracture.
From January 2012 to December 2012, 47 cases of femoral neck fracture were treated and included 25 males and 22 females with an average age of (44.58±10.32) years old ranging from 23 to 61 years old. All patients had a history of trauma, hip pain and movement limited, limb shortening extorsion deformity, X-ray showed fracture between femoral head and femoral neck basic. Among them, 32 cases were Garden type III and 15 cases were type IV. Patients were performed surgical treatment at 2 to 5 days after admission with 45 degrees abduction and extension position, internal rotation reduction, and 3 guide pins were inverted in a equilateral triangular structure of upside down arrangement. The postoperative recovery quality, fracture healing, femoral head necrosis and hip function were observed.
Operation time was 40 to 70 min, intraoperative bleeding was 20 to 50 ml. All patients received good reposition, and the intraoperative perspective was 12 to 25 times. Forty-five patients were followed up for 24 to 36 months, and 2 cases were lost. Fracture of 45 cases were got bony healing, 3 cases with partial necrosis of femoral head, both in the ARCO stage II. Twenty-four months after operation, Harris hip function score was 43.24±2.74 in pain, 42.82±1.95 in function, 3.72±0.45 in deformity, 2.77±0.52 in activity, 92.56±4.42 in total;the outcome was excellent in 39 cases, good in 4 cases, fair in 2 cases, without unbroken nails, infection, deep venous thrombosis, fracture and other complications.
Treatment of femoral neck fracture with the modified bone setting manipulation has an advantages of good effect, postoperative hip function recovery, curative effect.
分析改良闭合复位手法治疗股骨颈骨折的疗效。
选取2012年1月至2012年12月收治的47例股骨颈骨折患者，其中男25例，女22例，平均年龄（44.58±10.32）岁，年龄范围23至61岁。所有患者均有外伤史，髋部疼痛、活动受限，肢体短缩外旋畸形，X线显示股骨头与股骨颈基底部间骨折。其中，GardenⅢ型32例，Ⅳ型15例。患者入院后2至5天手术，采用外展45°伸直位，内旋复位，3枚导针呈倒等边三角形结构置入。观察术后恢复质量、骨折愈合情况、股骨头坏死情况及髋关节功能。
手术时间40至70分钟，术中出血20至50毫升。所有患者复位良好，术中透视12至25次。45例患者获随访24至36个月，失访2例。45例骨折均骨性愈合，3例股骨头部分坏死，均为ARCOⅡ期。术后24个月，Harris髋关节功能评分：疼痛43.24±2.74，功能42.82±1.95，畸形3.72±0.45，活动2.77±0.52，总分92.56±4.42；优39例，良4例，可2例，无断钉、感染、深静脉血栓、骨折不愈合等并发症。
改良复位手法治疗股骨颈骨折具有疗效好、术后髋关节功能恢复佳等优点。
