Objective:To investigate the clinical effect of internal fixation with closed reduction and hollow compression screws for the treatment of femoral neck fracture in young and middle-aged patients.Methods:From June 2013 to December 2016,33 young and middle-aged patients with femoral neck fractures were treated with hollow compression screws fixation in-cluding 17 males and 16 females with an average age of 38.5 years old ranged from 19 to 59 years old;20 cases were on the left side and 13 cases on the right side;the time from injury to operation ranged from 2 to 5 days with an average of 3 days.Accord-ing to Garden classification,1 case were typeⅠ,11 cases were typeⅡ,18 cases were typeⅢ,3 cases were typeⅣ.During regular follow-up after operation,through the hip joint X-ray,the healing situation of bone and osteonecrosis were observed.The Harris score was used to evaluate the hip function of the final follow-up.Results:The operation time was from 30 to 50 min-utes,the blood loss during operation was 20 to 70 ml.All patients were followed up for 8 to 42 months with an average of 24 months.At the final follow-up,the Harris score of hip joint was excellent in 18 cases,good in 10 cases,fair in 2 cases and poor in 3 cases.Among them,the pain scores were 40.61±5.08,function scores were 38.94±6.78,malformation scores were 3.88± 0.69,motion range scores were 3.70±0.64 and the total scores were 87.12±11.98.Thirty cases achieved bone healing,the heal-ing time was 4 to 12 months with an average of 7.5 months,2 patients occurred with nonunion(Garden typeⅣ),1 patient with femoral head necrosis(Garden typeⅣ).All patients had no postoperative infection,internal fixation loosening,refracture and other complications.Conclusion:In treating the young and middle-aged patients with femoral neck fracture,closed reduction and hollow compression screw fixation has advantages of simple,stable fixation,less trauma,high rate of fracture healing,os-teonecrosis of the femoral head with low risk and satisfactory clinical effect.%目的:探讨闭合复位加压空心螺钉内固定在中青年股骨颈骨折治疗的临床疗效.方法:自2013年6月至2016年12月采用闭合复位加压空心螺钉内固定治疗33例中青年股骨颈骨折,其中男17例,女16例,年龄19～59岁,平均38.5岁;左侧20例,右侧13例;受伤至手术时间为2～5 d,平均3 d.按照Garden 分型:Ⅰ型1例,Ⅱ型11例,Ⅲ型18例,Ⅳ型3例.术后定期随访,复查髋关节X线片,了解骨愈合和股骨头坏死情况,末次随访采用髋关节Harris功能评分进行疗效评价.结果:手术时间30～50 min,术中出血量20～70 ml.33例患者均获得随访,时间8～42个月,平均24个月.末次随访髋关节Harris功能评分:优18例,良10例,中2例,差3例,其中疼痛(40.61±5.08)分,功能(38.94±6.78)分,畸形(3.88±0.69)分,运动范围(3.70±0.64)分,总分(87.12±11.98)分.30例达到骨性愈合,愈合时间4～12个月,平均7.5个月,2例患者出现骨折不愈合(均为GardenⅣ型),1例患者发生股骨头坏死(GardenⅣ型),所有患者未出现术后感染、内固定松动、再骨折等并发症.结论:闭合复位加压空心螺钉内固定治疗中青年股骨颈骨折具有方法简单、创伤小、固定牢靠等优势,骨折愈合率高,股骨头坏死风险低,临床疗效满意.
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