CAJ | 학술논문

目的探讨应用股骨头、干三维互动复位技术治疗难复位性股骨颈骨折的效果.方法选择2011年6月-2013年7月收治的40例难复位性股骨颈骨折患者(研究组),术中应用股骨头、干三维互动技术进行骨折闭合复位,用3枚空心螺钉固定.术后摄股骨颈正、侧位X线片,根据Garden指数评估股骨颈骨折复位质量,根据髋关节Harris评分标准评估患髋功能恢复情况.同时回顾性分析2008年1月-2010年12月采用切开复位空心钉内固定治疗的32例难复性股骨颈骨折患者作为对照组.术后根据Harris评分评估患髋功能恢复情况. 结果研究组应用微创闭合技术复位满意.根据Garden指数评估,24例骨折复位质量为1级,16例为2级.32例患者获得平均21个月(12 ～28个月)随访,骨折均愈合,末次随访时患髋Harris评分为87分(61～ 100分),4例发生股骨头缺血性坏死.对照组6例骨折未愈合,末次随访时患髋Harris评分为60分(20～100分),8例发生股骨头缺血性坏死. 结论与传统切开复位技术相比,应用股骨头、干三维互动闭合复位技术可更好地治疗难复位性股骨颈骨折,患侧髋关节功能恢复良好,并可有效降低股骨头缺血性坏死、骨折不愈合发生率.
목적 탐토응용고골두、간삼유호동복위기술치료난복위성고골경골절적효과.방법 선택2011년6월-2013년7월수치적40례난복위성고골경골절환자(연구조),술중응용고골두、간삼유호동기술진행골절폐합복위,용3매공심라정고정.술후섭고골경정、측위X선편,근거Garden지수평고고골경골절복위질량,근거관관절Harris평분표준평고환관공능회복정황.동시회고성분석2008년1월-2010년12월채용절개복위공심정내고정치료적32례난복성고골경골절환자작위대조조.술후근거Harris평분평고환관공능회복정황. 결과 연구조응용미창폐합기술복위만의.근거Garden지수평고,24례골절복위질량위1급,16례위2급.32례환자획득평균21개월(12 ～28개월)수방,골절균유합,말차수방시환관Harris평분위87분(61～ 100분),4례발생고골두결혈성배사.대조조6례골절미유합,말차수방시환관Harris평분위60분(20～100분),8례발생고골두결혈성배사. 결론 여전통절개복위기술상비,응용고골두、간삼유호동폐합복위기술가경호지치료난복위성고골경골절,환측관관절공능회복량호,병가유효강저고골두결혈성배사、골절불유합발생솔.
Objective To investigate the therapeutic effect of three-dimensional interactive reduction of femoral neck and shaft in treatment of irreducible femoral neck fracture.Methods The study enrolled 40 patients with irreducible femoral neck fractures treated by three-dimensional interactive reduction of femoral neck/shaft and internal fixation with three cannulated screws from June 2011 to July 2013 (study group).Frontal and lateral X-ray films were taken after operation.Garden index was used to evaluate the fracture reduction quality and Harris hip score was recorded.Meanwhile,a retrospective analysis was performed on 32 patients with irreducible femoral neck fractures treated by open reduction and internal fixation with cannulated screws between January 2008 and December 2010 (control group).Results Patients in study group obtained satisfactory reduction by minimally traumatic closed reduction.According to the Garden index,fracture reduction quality was level 1 in 24 patients and level 2 in 16 patients.Thirty-two patients were followed up for 12-28 months (mean,21 months),which showed fracture healing.At the final follow-up,Harris hip score was 87 points (range,61-100 points) and 4 patients had femoral head avascular necrosis.By contrast,6 patients in control group showed fracture nonunion.At the final follow-up,Harris hip score was 60 points (range,20-100 points) and 8 patients had femoral head avascular necrosis.Conclusion Three-dimensional interactive reduction of femoral neck and shaft provides good hip function recovery and decreased incidence of femoral head avascular necrosis and fracture disunion compared with the open reduction and internal fixation.