不同手术方式治疗老年新鲜股骨颈骨折

发布时间：2018-03-13 22:43

本文选题：股骨颈骨折　切入点：切开复位内固定术　出处：《兰州大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：本文通过三种手术方式治疗FNF,比较闭合复位内固定、切开复位内固定+关节囊减压、全髋关节置换治疗FNF的疗效。方法：回顾性调查研究我院收治的老年新鲜FNF213例病例的临床资料。根据骨折类型分为非移位组(A组)、移位组(B组)。根据手术方式将A组分为闭合复位内固定组(A1)、切开复位内固定+关节囊减压组(A2)、人工关节全髋关节置换组(A3)；同理将B组分为B1、B2、B3。对所有病例系统追踪随访2年到3年,对术前、术中、术后各项指标进行全面评价及分析。结果：A1、A2手术时间、术中失血量显著优于A3,术后部分负重时间、术后负重时间较A3差；B1、B2手术时间、术中失血量显著优于B3,术后部分负重时间、术后负重时间较B3为差：A2术后髋关节Harris评分显著优于A1、A3：B2术后髋关节Harris评分显著优于B1、B3；B2术后股骨头缺血性坏死(ANFH)的发生率显著优于B1。结论：老年新鲜非移位型FNF,优先考虑外伤后6小时到24小时内行“FNF切开复位加压空心螺钉内固定术+关节囊减压术”治疗。老年新鲜移位型FNF,优先考虑行“FNF人工全髋关节置换术”治疗。临床治疗老年FNF应根据患者具体情况、手术适应证、患者诉求、手术者经验综合考虑慎重选择治疗方案。
[Abstract]:Objective: through three kinds of surgical treatment of FNF, compared with closed reduction and internal fixation, open reduction and internal fixation and joint capsule decompression, the efficacy of FNF in treating hip arthroplasty. Methods: clinical data of FNF213 cases of elderly fresh research in our hospital. According to fracture types are divided into non displaced group (A group), transposition group (group B). According to the operation mode of the A group was divided into internal fixation group (A1), open reduction and internal fixation and joint capsule decompression group (A2), artificial total hip replacement group (A3); in the B group was divided into B1, B2, B3. in all cases followed up 2 to 3 years, preoperative, intraoperative and postoperative indexes of comprehensive evaluation and analysis. Results: A1, A2, operation time, intraoperative blood loss was significantly higher than A3, part time weight after surgery, postoperative weight-bearing time is A3; B1 B2, operation time, blood loss in the operation of the rear is significantly superior to B3. Point load time, postoperative weight-bearing time than B3: A2 postoperative Harris hip score was significantly higher than A1, A3:B2 postoperative Harris hip score was significantly better than that of B1, B3; B2 after operation of femoral head avascular necrosis (ANFH) incidence rate was significantly higher than B1. conclusion: elderly fresh non displaced type FNF, is preferred. 6 hours after trauma to within 24 hours "FNF open reduction and hollow compression screw fixation + capsular decompression treatment. The elderly displaced FNF, priority for FNF total hip arthroplasty treatment. Clinical treatment of elderly patients with FNF should be based on specific conditions, surgical indications, patient demands, surgery considering the experience of carefully chosen treatment.

【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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