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三枚空心螺钉前内侧支撑钢板治疗青壮年 P a u w e l s Ⅲ型股骨颈骨折的疗效。

The effect of anteromedial support plate with three cannulated screws in the treatment of Pauwels type III femoral neck fracture in young adults.

机构信息

Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, Guangdong, People's Republic of China.

Department of Orthopedics, General Hospital of Southern Theater Command of PLA, No. 111, Liuhua Avenue, Guangzhou, 510010, China.

出版信息

Eur J Trauma Emerg Surg. 2022 Oct;48(5):4011-4017. doi: 10.1007/s00068-022-01931-0. Epub 2022 Mar 15.

Abstract

PURPOSE

This study is aimed to evaluate the clinical effects of anteromedial support plate combined with three cannulated screws on Pauwels type III femoral neck fractures in young adults.

METHODS

We conducted a retrospective study of 27 patients with Pauwels type III femoral neck fracture treated by anteromedial support plate combined with three cannulated screws. The results of fracture healing and complications for all patients were assessed by postoperative imaging examination. The Harris hip score was used to evaluate the functional outcome of the hip at the last follow-up.

RESULTS

The fracture union was achieved in 25 patients (92.6%). However, two patients required reoperation (two for nonunion). Early implant failure occurred in one patient, neck shortening in one patient and coxa vara in one patient. The excellent or good outcome of the Harris hip score was 96% for the 25 patients with satisfactory fracture union.

CONCLUSION

Our preliminary results indicate that anteromedial support plate combined with three cannulated screws is a good alternative in the treatment of Pauwels type III femoral neck fractures in young adults with high union rate and low incidence of complications including nonunion and avascular necrosis of the femoral head.

摘要

目的

本研究旨在评估前内侧支撑钢板联合三根空心螺钉治疗青壮年型 III 型股骨颈骨折的临床效果。

方法

我们回顾性研究了 27 例采用前内侧支撑钢板联合三根空心螺钉治疗的青壮年型 III 型股骨颈骨折患者。通过术后影像学检查评估所有患者的骨折愈合和并发症情况。末次随访时采用 Harris 髋关节评分评估髋关节的功能恢复情况。

结果

25 例患者(92.6%)骨折愈合。但有 2 例患者需要再次手术(2 例为骨不连)。1 例患者发生早期内固定失败,1 例患者发生颈缩短,1 例患者发生髋内翻。25 例骨折愈合满意的患者中,Harris 髋关节评分为优或良的比例为 96%。

结论

我们的初步结果表明,前内侧支撑钢板联合三根空心螺钉治疗青壮年型 III 型股骨颈骨折是一种较好的选择,具有较高的愈合率,且并发症发生率低,包括骨不连和股骨头缺血性坏死。

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