[1]唐立明 周广全 周驰 王海彬 庞智晖△.裂隙征在股骨颈骨折微观辨证论治中的意义[J].中国中医骨伤科杂志,2015,23(07):8-13.
　TANG Liming ZHOU Guangquan ZHOU Chi WANG Haibin PANG Zhihui.The Significance of Cleft Sign in Microscopic Diagnosis and Treatment for Femoral Neck Fracture[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2015,23(07):8-13.
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裂隙征在股骨颈骨折微观辨证论治中的意义
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第23卷
期数:
2015年07期
页码:
8-13
栏目:
临床研究
出版日期:
2015-07-15

文章信息/Info

Title:
The Significance of Cleft Sign in Microscopic Diagnosis and Treatment for Femoral Neck Fracture
文章编号:
1005-0205(2015)07-0008-06
作者:
唐立明1 周广全2 周驰1 王海彬1 庞智晖1; 2△
1.广州中医药大学第一附属医院三骨科(广州,510405)
2.广州中医药大学国家重点学科中医骨伤科学数字骨科与计算 生物力学实验室
△.通信作者 E-mail:rossse@126.com
Author(s):
TANG Liming1 ZHOU Guangquan2 ZHOU Chi1 WANG Haibin1 PANG Zhihui1; 2
1.The Third Department of Orthopedics, First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405,China;

<./sup>2Department of Traditional Chinese Medicine Traumatology Science Digital Orthopedics and Computational Biomechanics Laboratory of the National Key Disciplines of Guangzhou University of Traditional Chinese Medicine,Guangzhou 510405,China.
关键词:
中青年股骨颈骨折;  裂隙征;  空心加压螺钉结合腓骨移植;  微观辨证
Keywords:
femoral neck fracture in young and middle-aged;  cleft sign;  cannulated compression screws combined with fibular graft;  microcosmic syndrome differentiation
分类号:
R638.42
文献标志码:
A
摘要:
目的:探讨股骨颈骨折术后愈合过程中裂隙征的形成基础、演变规律和临床意义。方法:随访符合标准的105例患者,记录骨折的Garden分型、裂隙征的分级、裂隙征出现和消失的时间点、内固定构型的全程稳定性、股骨头坏死的发生和演变等指标,并采用SPSS18.0进行统计分析。结果:86.7%出现了裂隙征,2级裂隙征为26.7%; 内固定构型全程稳定性1级为81%,2级为19%,没有发生内固定失效和骨折不愈合。总病理学坏死率为80.1%; 总影像学坏死率为46.7%(49例),其中6.7%(7例)进展为临床坏死,其余的42例影像学坏死能维持为ARCO Ⅰ-Ⅱ期或者完全修复。股骨头幸存率超过90%.结论:裂隙征在骨折的愈合过程中相当普遍,并且对坏死股骨头的修复产生重要影响,安全渡过其失稳危险期是关键,本术式能够提供全程的生物力学稳定效能和持续有效的生物学修复能力,从而确保骨折的愈合,促进坏死修复,降低坏死的发生率和股骨头塌陷率。
Abstract:
Objective: To explore the forming, evolution and significance of cleft sign during healing process after femoral neck fracture operation.Methods:105 patients were followed up and the Garden type of fracture, cleft sign grade, the period time of cleft sign, the whole stability of internal fixation configuration and the occurrence and evolution indicators of femoral head necrosis were recorded. SPSS18.0 was used for statistical analysis. Results: Cleft sign was found in 86.7% patients, including 26.7% of 2 grade. The stability of internal fixation configuration of 1 grade was 81%, and 2 grade 19%. Fixation failure and fracture nonunion did not happen. The total pathology necrosis was 80.1%.The total radiological necrosis was 46.7%(49 cases),of which 6.7%(7 cases)progressed to clinical necrosis. The remaining 42 cases of radiological necrosis could be maintained for the ARCO Ⅰ-Ⅱ stage or fully restored. The femoral head survival rate was over 90%. Conclusion: Cleft sign in fracture healing process is quite common, and have a major impact on the repair of femoral head necrosis. Safety through its instability dangerous period is the key. This operation can provide the entire biomechanical stable efficiency, thus ensuring fracture healing, promoting necrosis repair and reducing the incidence rates of femoral head necrosis and collapse.

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备注/Memo

备注/Memo:
收稿日期:2014-05-11
基金项目:广东省科技计划项目(粤科函规财字[2014]807号)
广东省自然基金面上项目(S2013010011992)
广东省自然科学基金(博士启动)(S2014A030310214)
更新日期/Last Update: 2015-07-10