大转子截骨入路可吸收螺钉治疗股骨头骨折疗效分析

发布时间：2018-06-19 18:31

本文选题：股骨头骨折 + 大转子截骨　；参考：《中国矫形外科杂志》2017年06期

【摘要】：[目的]评估经大转子截骨入路可吸收螺钉固定治疗Pipkin I、II型股骨头骨折的中远期疗效。[方法]回顾性分析经大转子截骨入路可吸收螺钉治疗髋关节后脱位合并Pipkin I、II型股骨头骨折患者28例,男19例,女9例,平均年龄(41.54±2.51)岁(26~56岁);Pipkin I型17例,Pipkin II型11例,收集手术时间、术中出血量、股骨头坏死及异位骨化发生例数,功能评分采用Harris评分、改良Merle d’Aubigne-Postel评分,影像学评分采用Thompson-Epstein评分。[结果]1例女性及1例男性患者因失访从研究中剔除,剩余26例平均随访时间(35.42±1.63)个月(13~78个月),平均手术时间(1.35±0.45)h(0.85~1.84 h),平均术中出血量(237.41±35.25)ml(194~279 ml),截止末次随访,未出现异位骨化或股骨头缺血性坏死、髋关节脱位及坐骨神经症状。末次随访Harris评分平均(84.43±2.19)分,优良率为88.41%;改良Merle d’Aubigne-Postel评分(15.34±1.21)分,优良率为92.3%;Thompson-Epstein评价结果显示,优良率达88.47%(10例优,13例良,3例一般)。[结论]经大转子截骨入路对Pipkin I、II型股骨头骨折进行可吸收螺钉内固定术是一种有效的手术方法。
[Abstract]:[objective] to evaluate the mid-and long-term effect of transtrochanteric osteotomy with absorbable screw fixation in the treatment of Pipkin II femoral head fracture. [methods] 28 patients (19 males and 9 females) with posterior dislocation of hip associated with Pipkin I type II femoral head fracture were treated with absorbable screws via great trochanteric osteotomy. The mean age was 41.54 卤2.51 years old and 2656 years old. The operative time, intraoperative blood loss, femoral head necrosis and ectopic ossification were collected. Harris score was used for functional score, Aubigne-Postel score for modified Merle dome was used, and Thompson-Epstein score was used for imaging score. [results] one female and one male patient were excluded from the study because of the loss of visit. The average follow-up time of the remaining 26 cases was 35.42 卤1.63) months, the mean operative time was 1.35 卤0.45)h(0.85~1.84 / h, the mean intraoperative bleeding volume was 237.41 卤35.25)ml(194~279 / ml, and the last follow-up was completed. There were no ectopic ossification or avascular necrosis of femoral head, dislocation of hip and sciatic nerve. The average Harris score at the last follow-up was 84.43 卤2.19, the excellent and good rate was 88.41, and the improved Merle d 'Aubigne-Postel score was 15.34 卤1.21). The excellent and good rate was 92.33% and Thompson-Epstein evaluation results showed that the excellent and good rate was 88.47% in 10 cases, excellent in 13 cases and fair in 3 cases. [conclusion] Transtrochanteric osteotomy is an effective method for the treatment of Pipkin II femoral head fracture with absorbable screws.
【作者单位】：中国人民解放军第二军医大学附属长海医院创伤骨科;上海市静安区中心医院;
【基金】：国家自然科学基金资助项目(编号:31271031);国家自然科学基金重大国际合作项目(编号:8141101156) 军队后勤项目(编号:CWS13J044)
【分类号】：R687.31

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