CAJ | 학술논문

目的：探讨双肌蒂髂骨瓣结合3枚空心钉治疗青壮年新鲜股骨颈骨折的疗效。方法对23例有移位的青壮年新鲜股骨颈骨折患者( Garden Ⅲ型17例,Garden Ⅳ型6例)行切开复位、3枚空心钉固定,取缝匠肌阔筋膜张肌髂骨瓣植入股骨头颈槽内、克氏针内固定。结果所有患者均获随访,时间25~36个月。22例骨折愈合,时间4~8个月；1例骨不愈合并股骨头缺血坏死( Ficat Ⅲ期)；1例骨折愈合患者术后18个月随访时发现股骨头坏死( FicatⅡ期)。髋关节功能按Harris评分标准：优14例,良5例,可3例,差1例。结论早期手术、解剖复位、应用双肌蒂髂骨瓣结合3枚空心钉治疗有移位的青壮年新鲜股骨颈骨折,可促进股骨颈骨折愈合,早期效果满意。重视手术操作、合适的术后康复,对提高临床疗效有重要意义。
목적：탐토쌍기체가골판결합3매공심정치료청장년신선고골경골절적료효。방법대23례유이위적청장년신선고골경골절환자( Garden Ⅲ형17례,Garden Ⅳ형6례)행절개복위、3매공심정고정,취봉장기활근막장기가골판식입고골두경조내、극씨침내고정。결과소유환자균획수방,시간25~36개월。22례골절유합,시간4~8개월；1례골불유합병고골두결혈배사( Ficat Ⅲ기)；1례골절유합환자술후18개월수방시발현고골두배사( FicatⅡ기)。관관절공능안Harris평분표준：우14례,량5례,가3례,차1례。결론조기수술、해부복위、응용쌍기체가골판결합3매공심정치료유이위적청장년신선고골경골절,가촉진고골경골절유합,조기효과만의。중시수술조작、합괄적술후강복,대제고림상료효유중요의의。
Objective To study the effect of the treatment of fresh femoral neck fractures in young adults by using three hollow screws and pedicled iliac bone flaps with sartorius and tensor fasciae latae. Methods 23 cases of femo-ral neck fractures with transposing in young adults,included 17 cases of Garden type Ⅲ and 6 cases of Garden typeⅣ,which were treated by open reduction and three hollow screws fixation, pedicled iliac bone flaps with sartorius and tensor fasciae latae were implanted into femoral head and neck, and fixed with Kirschner wire. Results All the 23 cases were followed up for 25~36 months. 22 cases were cured, and the fracture healing time was 4~8 months. 1 case occurred bone nonunion and femoral head necrosis. 1 case with fracture healing occurred femoral head necrosis in 18 months after the operation ( FicatⅡ) . According to Harris score of hip joint function, 14 cases were excellent, 5 good, 3 fair, and 1 poor. Conclusions Early surgery,anatomical reduction, using three hollow screws and pedi-cled iliac bone flaps with sartorius and tensor fasciae latae,which can improve the healing of the femoral neck frac-tures in the young adults and reduce the occurrence of nonunion and a vascular necrosis of femoral head. Early results are satisfactory. Efficient iliac flap grafting, appropriate postoperative rehabititation are the keys to improve the clinical efficacy.