[1]侯洪涛 陈柯 刘又文 仝昭方 海洋 吴亦新 马文龙 陈武林 王坤正△.老年股骨颈Garden Ⅲ型骨折内固定治疗的临床研究[J].中国中医骨伤科杂志,2016,24(08):32-36.
　HOU Hongtao CHEN Ke LIU Youwen TONG Zhaofang HAI Yang WU Yixin MA Wenlong Chen Wulin WANG Kunzheng.Clinical Study on the Treatment of Elderly Patients with Garden Type Ⅲ Femoral Neck Fracture Treated with Internal Fixation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2016,24(08):32-36.
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老年股骨颈Garden Ⅲ型骨折内固定治疗的临床研究
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第24卷
期数:
2016年08期
页码:
32-36
栏目:
临床研究
出版日期:
2016-08-01

文章信息/Info

Title:
Clinical Study on the Treatment of Elderly Patients with Garden Type Ⅲ Femoral Neck Fracture Treated with Internal Fixation
文章编号:
1005-0205(2016)08-0033-04
作者:
侯洪涛1 陈柯1 刘又文1 仝昭方1 海洋1 吴亦新1 马文龙1 陈武林1 王坤正2△
1.河南省正骨研究院髋部疾病研究治疗中心(河南 洛阳,471002)
2.西安交通大学第二附属医院
△.通信作者 E-mail:wkzh1955@163.com
Author(s):
HOU Hongtao1 CHEN Ke1 LIU Youwen1 TONG Zhaofang1 HAI Yang1 WU Yixin1 MA Wenlong1 Chen Wulin1 WANG Kunzheng2△
1.Orthopedic Institute of Henan Province,Luoyang 471002,Henan China;
2.The Second Affiliated Hospital,Xi'an Jiaotong University,Xi'an 710004,China.
关键词:
闭合复位;  股骨颈骨折;  骨折不愈合;  股骨头坏死;  老年;  内固定术
Keywords:
closed reduction;  femoral neck fracture;  nonunion;  femoral head necrosis;  aged;  internal fixation
分类号:
R683.42
文献标志码:
A
摘要:
目的:探讨老年GardenⅢ型股骨颈骨折闭合手法复位内固定术中的继发移位对骨折不愈合及股骨头坏死的影响。方法:闭合复位空心钉内固定治疗老年GardenⅢ型股骨颈骨折257例,并对复位术中有无继发移位的两组治疗结果及疗效行统计分析。结果:随访60～120个月,平均86个月。无继发移位组骨折不愈合率9.7%,股骨头坏死率12.2%,髋关节功能Harris评定优良率87.3%.继发移位组分别为16.4%,27.9% 和73.7%.两组股骨头坏死率及疗效比较,差异有统计学意义(P<0.05)。结论:老年GardenⅢ型股骨颈骨折复位术中的继发移位与术后股骨头坏死相关。避免骨折复位术中的继发移位,可能会降低内固定术后发生股骨头坏死的风险。
Abstract:
Objective:To discuss the effect of secondary displacement during closed reduction on the fracture nonunion and femoral head necrosis of Garden Ⅲ femoral neck fracture in the aged.Methods:257 elderly patients with Garden Ⅲ femoral neck fracture were treated by closed reduction and internal fixation with cannulated screws.Curative effect between secondary displacement group and no secondary displacement group were analyzed by statistic system.Results:Followed up from 60 to 120 months with average 86 months.The nonunion rate of no secondary displacement group was 9.7%,the rate of femoral head necrosis was 12.2%,and the hip joint function was Harris,and the excellent rate of Harris score was 87.3%.While they were 16.4%,27.9% and 73.7% respectively in secondary displacement group.There was significant difference in the rate of femoral head necrosis between the two groups(P<0.05).Conclusions:Secondary displacement in elderly patients with Garden type Ⅲ femoral neck fracture is positively correlated with femoral head necrosis.Avoiding secondary displacement during closed reduction may reduce the risk of femoral head necrosis.

参考文献/References:

[1]张英泽.股骨颈骨折治疗方案选择策略与进展[J].中国骨伤,2015,28(9):781-783.
[2] Lee YK,Ha YC,Park C,et al.Trends of surgical treatment in femoral neck fracture:a nationwide study based on claim registry[J].J Arthroplasty,2013,28(10):1839-1841.
[3] Su EP,Su SL.Femoral neck fractures:a changing paradigm[J].J Bone Joint Surg,2014,96(11 Suppl A):43-47.
[4] 何飞宇,梅亮.微创加压空心螺钉治疗股骨颈骨折81例[J].中国中医骨伤科杂志,2011,19(8):45.
[5] Miller BJ,Callaghan JJ,Cram P,et al.Changing trends in the treatment of femoral neck fractures:a review of the American board of orthopaedic surgery database[J].J Bone Joint Surg Am,2014,96(17):e149.
[6] 刘俊,罗政.老年移位性股骨颈骨折手术方案的选择[J].中国中医骨伤科杂志,2014,22(8):51-52.
[7] 李宇能.基于循证医学的股骨颈骨折治疗[J].国际骨科学杂志,2016,37(1):5-7.
[8] 刘国泰,张志强,刘杰,史晓林.两种术式治疗骨质疏松性股骨颈骨折疗效对比[J].中国中医骨伤科杂志.
[9] Borissova AM,Rashkov R,Boyanov M,et al.Femoral neck bone mineral density and 10-year absolute fracture risk in a national representative sample of Bulgarian women aged 50 years and older[J].Arch Osteoporos,2011,6:189-195.
[10] Garden RS.Low-angle fixation in fractures of the femoral neck[J].J Bone Joint Surg Br,1961,43:647-663.
[11] Garden RS.Stabilty and union in subcapital fractures of the femur[J].J Bone Joint Surg Br,1964,46-B(4):633.
[12] Garden RS.Malreduction and avascular necrosis in subcapital fractures of the femur[J].J Bone Joint Surg Br,1971,53(2):183-197.
[13] 卢庆弘,余锋平.影响空心加压螺钉治疗股骨颈骨折骨愈合的因素分析[J].中国骨伤,2012,25(12):1041.
[14] 王清富,石峰,陈庄洪,等.影响空心加压螺钉治疗股骨颈骨折愈合的因素分析[J].中国中医骨伤科杂志,2013,21(8):34-36,39.
[15] 许斌,刘月驹,李智勇,等.股骨颈骨折不愈合高危因素的回顾性研究[J].中华创伤杂志,2012,28(12):1083-1087.
[16] 顾小明,黄立新.股骨颈骨折空心加压螺钉内固定后股骨头坏死分析[J].实用骨科杂志,2014,20(10):900-904.
[17] 薛晨曦,荆珏华,徐杰,等.选择性血管造影评价股骨颈骨折后股骨头血供变化[J].临床骨科杂志,2014,17(2):149-154.
[18] 申锋,闫作勤,部长安,等.SPECT-CT评价股骨颈骨折后股骨头血供的变化[J].中华关节外科杂志(电子版),2012,6(2):6-9.
[19] 蔡小强,范觉昕,沈利明,等.选择性旋股内动脉造影对股骨颈骨折后股骨头血供的观察[J].内蒙古中医药,2010,(12):101-102.
[20] 刘洋,游浩,高劲松,等.应用选择性血管造影技术评价股骨颈骨折后股骨头血供情况及其对临床治疗的指导作用[J].中国骨与关节外科,2010,3(4):276-297.

更新日期/Last Update: 2016-08-02