Lindequist S, Törnkvist H
Department of Orthopedics, Huddinge Hospital, Karolinska Institutet, Sweden.
J Orthop Trauma. 1995 Jun;9(3):215-21. doi: 10.1097/00005131-199506000-00006.
The aim of this study was to compare the quality of reduction and the position of the fixating screws with the rate of union in 72 femoral neck fractures. The degree of fracture displacement after reduction and the position of the two fixating screws were determined with a new computerized measuring method that compensates for the variations in hip rotation in routine radiographs. All 13 nondisplaced fractures united. Sixteen of 18 fractures healed in the group of displaced fractures where both the fixating screws were placed within 3 mm from the femoral neck cortex, compared with 13 of 22 healed fractures in the group where only one screw had the same close contact with the femoral neck cortex (p < 0.05). Nonunion developed in all five displaced fractures where none of the two fixating screws were placed within 3 mm from the femoral neck cortex. The quality of reduction did not affect the healing rate; however, the number of poorly reduced fractures was only 10%. The results of this study underline the importance of achieving cortical support for the fixating screws in femoral neck fracture surgery.
本研究的目的是比较72例股骨颈骨折复位质量、固定螺钉位置与骨折愈合率之间的关系。采用一种新的计算机测量方法来确定复位后骨折移位程度及两枚固定螺钉的位置，该方法可弥补常规X线片上髋关节旋转的差异。所有13例无移位骨折均愈合。在移位骨折组中，18例中有16例骨折愈合，其两枚固定螺钉均位于距股骨颈皮质3mm以内；相比之下，在仅一枚螺钉与股骨颈皮质有相同紧密接触的组中，22例骨折中有13例愈合（p<0.05）。在两枚固定螺钉均未位于距股骨颈皮质3mm以内的所有5例移位骨折中均发生了骨不连。复位质量并未影响愈合率；然而，复位不佳的骨折数量仅为10%。本研究结果强调了在股骨颈骨折手术中实现固定螺钉皮质支撑的重要性。
