摘要
目的 探讨股骨颈骨折内固定加带蒂骨瓣移植术后发生骨不连和股骨头缺血坏死的相关因素。方法 将得到长期随访的 2 13例股骨颈骨折患者按治疗方法分为 2组 :A组仅用加压螺纹钉内固定 ,B组用加压螺纹钉加带蒂骨瓣移植。随访 3 0～ 82个月 ,平均 ( 5 2± 4)个月。分别将其骨不连及股骨头坏死的发生率进行统计分析。结果 A组共182例 ,172例骨折愈合 ,愈合率为 94.5 %。骨不连GardenⅡ型 3例 ,Ⅲ型 3例 ,Ⅳ型 4例。股骨头缺血坏死 2 5例 ,坏死发生率 13 .8% ;其中GardenⅠ型 1例 ,Ⅱ型 4例 ,Ⅲ型 7例 ,Ⅳ型 13例。B组共 3 1例 ,骨折全部愈合 ,愈合率为 10 0 .0 %。股骨头缺血坏死 3例 ,发生率为 9.7% ;均发生于GardenⅣ型。结论 加用带蒂骨瓣移植治疗股骨颈骨折可降低其骨不连发生率 ,但不能改善股骨头缺血坏死 。
objective To observe the factors which definitely influence the bone nonunion and necrosis of femoral head after internal fixation of femoral neck fracture. Methods 213 cases,followed-up for 30～82 months, average 52±4 months,were divided into 2 groups according to different treated-ways:A group was treated with compression screws;B group was treated with compression screw and pedicled bone graft.To analyz the data about the rate of bone nonunion and necrosis. Results The rate of healing and necrosis were 94.5% in A group(172/182) and 13.8%(25/182) respectively.Necrosis happened in Garden Ⅰ 1 case; Garden Ⅱ 4 cases; Garden Ⅲ 7 cases; Garden Ⅳ 13 cases.All fractures were healed in B group;the rate of femoral head necrosis was 9.7%(3/31),which developed in Garden Ⅳ. Conclusion Treating the femoral neck fracture adding pedicled bone graft can decrease the rate of bone nonunion, but was of no use in decreasing the femoral neck necrosis. The latter is closely related to the degree of the original displacement in the femoral neck fracture.
出处
《现代医学》
2004年第4期238-240,共3页
Modern Medical Journal
