Bray T J, Chapman M W
Instr Course Lect. 1984;33:168-79.
Femoral neck fractures constitute one third of all hip fractures in the United States. The literature suggests union rates from 85% to 95% and late segmental collapse between 7% and 12% in fractures treated by internal fixation. We advocate percutaneous pinning in situ for all nondisplaced fractures of the femoral neck (Garden stages I and II). Displaced fractures of the femoral neck (Garden stages III and IV) are manually reduced, fluoroscopically evaluated as described, and percutaneously pinned. Postoperatively these patients are allowed immediate full weight bearing. Although hemiarthroplasty has been advocated, complications including dislocation, deep wound infection, loosening, protrusio, and component migration, far outweight the relatively minor problems facing the surgeon with a failed percutaneous pinning. Secondary femoral head replacements for failed percutaneous pinnings have a substantially lower incidence of complications than primary replacements for the treatment of acute femoral neck fractures.
在美国，股骨颈骨折占所有髋部骨折的三分之一。文献表明，采用内固定治疗的骨折，愈合率为85%至95%，后期节段性塌陷率为7%至12%。我们主张对所有无移位的股骨颈骨折（Garden I期和II期）进行原位经皮穿针固定。股骨颈移位骨折（Garden III期和IV期）先进行手法复位，然后按所述方法在透视下评估，并经皮穿针固定。术后这些患者可立即完全负重。尽管有人主张采用半髋关节置换术，但包括脱位、深部伤口感染、松动、髋臼内陷和假体移位在内的并发症，远远超过了经皮穿针失败给外科医生带来的相对较小的问题。经皮穿针失败后进行二次股骨头置换的并发症发生率，远低于治疗急性股骨颈骨折的初次置换。
