Nieminen S, Nurmi M, Satokari K
Ann Chir Gynaecol. 1981;70(1):26-31.
In the present study, the influence on healing of femoral neck fractures of reduction of the fracture and the age of the patients were investigated in 446 consecutive cases treated by internal fixation. If the fracture was reduced in valgus position anteroposteriorly, 90% of the cases healed, and if anatomical reduction was achieved the figure was 77%. However, if the fracture remained in varus position bone union was obtained in only 63%. After a good lateral reduction internal fixation resulted in failures in 22% of cases, if a satisfactory in 26%, but poor lateral reduction was followed by failure in 49% of cases. There was correlation to reduction position in all Garden's Stages. With regard to the healing of the fracture, reduction in lateral as well as anteroposterior views were of equal importance. The patient's age did not influence the failure rate in 22% of cases. With increasing age progressive decrease of healing was encountered. The number of patients attending for follow-up until bony union decreased also due to a high mortality rate in these patients. Internal fixation was found to be the treatment of choice in femoral neck fractures, provided that a satisfactory reduction could be obtained.
在本研究中，对446例接受内固定治疗的连续病例进行了调查，以研究骨折复位和患者年龄对股骨颈骨折愈合的影响。如果骨折在前后位呈外翻位复位，90%的病例愈合；如果实现解剖复位，这一数字为77%。然而，如果骨折仍处于内翻位，只有63%的病例实现骨愈合。良好的侧方复位后，22%的病例内固定失败；复位满意时，失败率为26%；但侧方复位不佳时，49%的病例出现失败。在所有Garden分期中，均与复位位置相关。就骨折愈合而言，侧位及前后位的复位同样重要。22%的病例中患者年龄不影响失败率。随着年龄增长，愈合逐渐减少。由于这些患者的高死亡率，直至骨愈合前来随访的患者数量也减少。如果能获得满意的复位，内固定被认为是股骨颈骨折的首选治疗方法。
