Li Ying-Zhou, Ye Feng, Wan Lei, Yang Yong-Bo, Chen Yuan-Sheng, Wang Xiao
Department of Orthopaedics, Shangyu Hospital of Traditional Chinese Medicine, Shangyu 312300, Zhejiang, China;
Department of Orthopaedics, Shangyu Hospital of Traditional Chinese Medicine, Shangyu 312300, Zhejiang, China.
Zhongguo Gu Shang. 2018 Feb 25;31(2):120-123. doi: 10.3969/j.issn.1003-0034.2018.02.005.
To investigate the preliminary effects of modified percutaneous compression plate in treating femoral neck fractures of Pauwels type III.
From March 2012 to March 2016, 35 patients with femoral neck fracture were treated by closed reduction and internal fixation with a modified percutaneous compression plate, including 21 males and 14 females with an average age of 45 years old ranging from 23 to 62 years old. The anatomical position of fracture was divided into 8 cases of lower head type, 27 cases of head and neck. According to the Garden classification, there were 8 cases of type II, 18 of type III, and 9 of type IV fractures. All patients were closed injury. The general information, reduction quality, fracture healing time, postoperative complications were recorded and evaluated. Harris scoring was used to evaluate the hip joint function.
All patients were followed up for 15 to 24 months with an average of 20 months. All the incisions were primary healing. The reduction quality of the femoral neck fracture was evaluated according to the Garden's alignment Index, and the quality of reduction was grade I reduction in 29 cases and grade II reduction in 6 cases. No nonunion, femoral avascular necrosis, implant failure and hip varus was observed during follow-up. Harris score was(92.70±4.60) points at final follow-up, the results of the treatment was evaluated as excellent in 26 cases, good in 8 cases, fair in 1 case. No complications such as internal fixation loosening, nail breaking, and heterotopic ossification occurred.
Internal fixation with modified percutaneous compression plate has an advantages of decreased trauma, simple operation, rigid fixation, good function outcome, and low risk of complications.
探讨改良型经皮加压钢板治疗 Pauwels Ⅲ型股骨颈骨折的初步疗效。
选取 2012 年 3 月至 2016 年 3 月采用改良型经皮加压钢板进行闭合复位内固定治疗的 35 例股骨颈骨折患者，其中男性 21 例，女性 14 例，平均年龄 45 岁（23～62 岁）。骨折解剖位置分为下头型 8 例，头颈部 27 例。按 Garden 分型，Ⅱ型 8 例，Ⅲ型 18 例，Ⅳ型 9 例。所有患者均为闭合伤。记录并评估患者的一般资料、复位质量、骨折愈合时间、术后并发症。采用 Harris 评分评估髋关节功能。
所有患者均获随访，随访时间 15～24 个月，平均 20 个月。所有切口均一期愈合。根据 Garden 对线指数评估股骨颈骨折复位质量，复位质量为Ⅰ级 29 例，Ⅱ级 6 例。随访期间未观察到骨不连、股骨头缺血坏死、内固定失败及髋内翻。末次随访时 Harris 评分为（92.70±4.60）分，治疗结果评定为优 26 例，良 8 例，可 1 例。未出现内固定松动、断钉及异位骨化等并发症。
改良型经皮加压钢板内固定具有创伤小、操作简单、固定可靠、功能恢复好、并发症风险低等优点。
