Hernigou P, Besnard P
Hôpital Henri Mondor, Creteil, France.
J Bone Joint Surg Br. 1997 Mar;79(2):285-8. doi: 10.1302/0301-620x.79b2.7109.
Plain radiographs show only two dimensions of a three-dimensional object. On anteroposterior and lateral radiographs an implant may appear to be safely within the head of the femur although surface penetration has occurred. We have attempted to identify this complication in the treatment of fractures of the femoral neck and have analysed the position of a screw or pin in the femoral head and neck on the basis of orthogonal frontal and lateral radiographs. A retrospective analysis of 60 cases of osteosynthesis of fractures of the femoral neck confirmed the risk of non-recognition of articular penetration or breaking of the cortex of the neck during surgery. Unrecognised screw penetration of the hip was observed in 8% and of the posterior part of the neck in 10%. The risk differs according to the type of fracture: it is greater in the coxa valga produced by Garden-I fractures of the femoral neck.
普通X线片仅显示三维物体的两个维度。在前后位和侧位X线片上，尽管植入物已穿透表面，但看起来可能仍安全地位于股骨头内。我们试图在股骨颈骨折治疗中识别这种并发症，并根据正交的正位和侧位X线片分析螺钉或钢针在股骨头和颈部的位置。对60例股骨颈骨折内固定病例的回顾性分析证实了手术中未识别出关节穿透或颈部皮质破裂的风险。观察到8%的病例存在未被识别的螺钉穿透髋关节情况，10%的病例存在螺钉穿透颈部后部的情况。风险因骨折类型而异：在股骨颈Garden-I型骨折导致的髋外翻中风险更大。
