股骨干顺行髓内钉固定后同侧股骨颈骨折的治疗

摘要

目的:探讨股骨干骨折行顺行髓内钉固定后发现同侧股骨颈骨折的治疗方法.方法:回顾性分析2000年1月至2010年1月股骨干骨折行顺行髓内钉固定后术中或术后发现同侧股骨颈骨折的患者12例,全部以2枚螺钉分别自髓内钉前后方固定股骨颈骨折,定期随访,评估骨折愈合及功能恢复情况.结果:术后随访10～36个月,平均16.5个月.股骨颈骨折平均愈合时间3.6个月,股骨干骨折平均愈合时间5.4个月,无股骨头坏死发生.按Harris评分标准髋关节功能:优7例,良3例,可2例.结论:股骨干骨折顺行髓内钉固定后发现同侧股骨颈骨折,以2枚螺钉分别自髓内钉前后方固定股骨颈骨折方法可行,固定可靠,手术创伤小,骨折愈合率高.%Objective:To investigate the treatment of femoral neck fractures after the fixation of ipsilateral femoral shaft fracture by antegrade intramedullary nail. Methods:A retrospective study on 12 patients with femoral neck fractures after the fixation of ipsilateral femoral shaft fracture by antegrade intramedullary nail, which were identified intraoperatively or postoper-atively from January 2000 to January 2010. All the patients were treated with 2 supplemental screws placed anteriorly and posteriorly to intramedullary nail seperately. All the patients were periodic followed-up, fractures union and functional recovery were evaluated. Results:All the patients were followed up,and the duration ranged from 10 to 36 months (averaged 16.5 months). The mean healing time was 3.6 months in femoral neck fractures and 5.4 months in femoral shaft fractures. No os-teonecrosis of femoral head was found. According to Harris scoring system for hip function, 7 patients got an excellent result, 3 good,2 fair. Conclusion:Treatment of femoral neck after the fixation of ipsilateral femoral shaft by antegrade intramedullary nail with 2 screws placed anteriorly and posteriorly to intramedullary nail separately is feasible,and has the advantages of reliable fixation, less trauma and high rate of fracture healing.