闭合复位经皮空心加压螺纹钉治疗老年股骨颈骨折的预后及并发症.pdf

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1、医学2014年4月第25卷第4期MedJChinPAPF．V01．25．N0．4．ADril．2014357闭合复位经皮空心加压螺纹钉治疗老年股骨颈骨折的预后及并发症严怀宁，张晓峰，潘永飞，叶荣，高锋，段艳伟，文立【摘要】目的探讨老年股骨颈骨折患者闭合复位经皮空心螺钉术后的预后及并发症。方法回顾性分析本院经空心加压螺纹钉治疗的老年股骨颈骨折145例，其中GardenI型22例，Ⅱ型55例，Ⅲ型52例，Ⅳ型16例；术后2年随访患者术后并发症，股骨头坏死或骨折不愈合的情况以及患肢功能。结果术后GardenI一Ⅳ型发生骨折不愈合或者缺血性坏死的发生率分别为4．5

2、％、3．6％、15．4％、31．3％。术后并发症的发生率在Garden分型的四型中差异无统计学意义。结论闭合复位经皮空心螺钉术对于老年股骨颈骨折患者是一个有效的方法，特别在GardenI型和GardenⅡ型的患者中应是首选治疗方法。【关键词】股骨颈骨折；老年患者：闭合复位；空心螺钉固定术【中国图书分类号】R473．71AretrospectivestudyofclosereductionpluspercutaneouscannulatedscrewfixationforfemoralneckfracturesinelderlypatientsYANHuai

3、ning，ZHANGXiaofeng，PANyongfei，YERong，GA0Feng，DUANYanwei，andWENLi．DepartmentofOrthopae—dic，NajingHospitalofJiangsuProvincialCorps，ChinesePeople’SArmedPoliceForces，Nanjing210028，China【Abstract】ObjectiveToevaluatetheresultsandcomplicationsoffemoralneckfracturesinelderlypatientstreate

4、dwithclosereductionpluspercutaneouscannulatedscrewfixation．MethodsWeretrospetivelyⅣelystudied145patientsolderthan60yearswhopresentedwithfemoralneckfracturesthatunderwentcannulatedscrewfixationbetween2003and2011．Theresultsof145patientsthathad2-yearfollow·upincludedpostoperativecomp

5、licationsandhipjointfunctionwhichwasevaluatedaccordingtotheHarrisscore．Gardenclassificationwasuseforthepatients，22ofwhomweretypeI，55weretypeI1，52weretype111，16weretypeⅣ．ResultsTheincidencesofnonunionoravascularnecrosiswere4．5％，3．6％，15．4％，and31．3％inthepatientswhowereclassifiedasGar

6、denI，GardenII，Gardenm，andGardenⅣrespectively．TherewerenostatisticaldifferencesintherateofpostepercativeivecomplicationsinthepatientswithGardenclassification．TherateofpostepercativeivecomplicationsinthepatientswithASA111washigherthanthsseinASAIandASAⅡ．ConclusionsClosereductionplusp

7、ercutaneouscannulatedscrewfixationiSaneffectiveivemethodfortreatingfemoralneckfracturesinthepatientsmorethan60tearsoldandisapriormethodinthepatientsofGardenIandGardenII押pes．【Keywords】femoralneckfracture；elderlypatients；closereduction；cannulatedscrewfixation股骨颈骨折是老年患者常见的骨折，常常由于率。但是

8、，国内外均有研究报道，老年股骨颈骨折行低能量的损伤导致⋯。尽管外科