移位型股骨颈骨折内固定的临床观察

摘要

Objective: To explore the displaced femoral neck fracture fixation operation time and postoperative complications.Methods: A retrospectively comparative study selected cases based on the following criteria, age 30-75; length of stay less than 48 hours; Garden Ⅲ, Ⅳ patients with femoral neck were carried out internal fixation, external fixation did not include, traction and cast immobilization and artificial joint replacement; followed up for 24 months.192 patients meeting the above criteria at the time from injury to surgery were divided into two groups, group A wss ≤ 24 hour operation (76 cases), group B was ＞24 hours of surgery (116 cases), in the two groups length of hospital stay, ICU time, combined with shock, wound infection, lung infection, femoral head necrosis were compared.Results: The hospital stay, combined with shock rate, the rate of femoral head necrosis after surgery, there were significant differences in the two groups (all P＜0.001), and there was no significant difference on the other complication in the two groups (all P＞0.05).Conclusion: The recovery operation as soon as possible the anatomic relationship of femoral neck, can greatly reduce the length of hospital stay and postoperative incidence of femoral head necrosis, thereby reduce the health care cost.%目的:探讨移位型股骨颈骨折内固定手术时机及术后并发症的发生.方法:采用回顾性对比研究,依据下列标准选择病例,年龄30～75岁;住院时间不少于48 h;GardenⅢ、Ⅳ型股骨颈患者,均进行了内固定手术,不包括外固定支架、牵引及石膏固定和人工关节置换者;随访时间24个月.将符合上述标准的192例按受伤至手术时间分为两组.A组为＜24 h手术者(76例),B组为＞24 h手术者(116例),将两组间住院时间、ICU时间、合并休克、伤口感染、肺部感染、股骨头坏死率情况进行比较.结果:经统计学处理,两组的住院时间、合并休克率、术后股骨头坏死率差异均有高度统计学意义(均P＜0.001),而在其他方面差异均无统计学意义(均P＞0.05).结论:尽快手术恢复股骨颈的解剖关系,可大大降低住院时间及术后股骨头坏死的发生率,从而减少医疗费用.