摘要
目的：回顾性探讨负重时机对老年股骨颈GardenⅢ型骨折内固定术后内固定失效、骨折不愈合及术后早期股骨头坏死的影响。方法：选择2012年3月～2014年3月采用闭合复位空心钉内固定术治疗的老年股骨颈GardenⅢ型骨折149例，按术后负重时机分为中晚期负重组82例、早中期负重组67例。比较2组内固定失效、骨折不愈合、术后2年发生股骨头坏死情况及疗效。结果：随访24个月，中晚期负重组内固定失效率4．9％、骨折不愈合率8．5％、股骨头坏死率7．3％、髋关节功能Harris评分优良率80．5％，早中期负重组分别为21．0％、21．0％、17．9％和55．2％，2组差异均有统计学意义（ P＜0．05）。结论：老年股骨颈GardenⅢ型骨折内固定术后内固定失效、骨折不愈合及早期股骨头坏死与负重时机相关，中晚期负重可能有利于减少内固定失效、骨折不愈合及术后早期股骨头坏死。
Objective：To retrospectively study the effects of weight bearing time on internal fixation ineffectiveness,nonunion and early postoperative femoral head necrosis of GardenⅢfemoral neck fracture treated by internal fixation for the aged.Methods：A total of 149 older patients with GardenⅢfemoral neck fractures from March 2012 to March 2014,which were treated by closed reduction and internal fixation with cannulated compression screws,were divided into early-middle weight bearing group including 67 cases and middle-late weight bearing group including 82 cases according to postoperative different weight bearing time .Statistical indicators, including internal fixation ineffectiveness,nonunion,early postoperative femoral head necrosis and curative effect,were analyzed by SPSS21.0 statistic sys-tem.Results：The followed-up study with 24 months showed internal fixation ineffectiveness 4.9%,nonunion 8.5%,early postoperative femoral head necrosis 7.3%and hip function better and excellent 80.5%according to Harris hip joint score in middle-late weight bearing group.They were 21.0%,21.0%,17.9%and 55.2%in early-middle weight bearing group.There existed significant difference be-tween two groups（P〈0.05）.Conclusion：Weight bearing time concerns internal fixation ineffectiveness,nonunion and early postopera-tive femoral head necrosis of GardenⅢfemoral neck fracture treated by internal fixation for the aged.Middle-late weight bearing may be propitious to reduce internal fixation ineffectiveness,nonunion and early postoperative femoral head necrosis.
作者
侯洪涛
陈柯
仝昭方
海洋
王坤正
HOU Hong -tao CHEN Ke TONG Zhao -fang et al(Department of Orthopedic, The Hospital of Henan Province, Luoyang 471002, Henan, China.)
出处
《中国伤残医学》
2016年第20期1-3,共3页
Chinese Journal of Trauma and Disability Medicine
关键词
负重
股骨颈骨折
骨折不愈合
股骨头坏死
内固定术
Weight bearing
Femoral neck fracture
Fractures,Nonunited
Femoral head necrosis
Internal fixation
