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改良髋关节前方入路治疗Pipkin Ⅰ、Ⅱ型股骨头骨折 预览

Efficacy of modified anterior approach in treating Pipkin type Ⅰ and Ⅱ femoral head fractures
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摘要 目的探讨应用改良髋关节前方入路治疗PipkinⅠ、Ⅱ型股骨头骨折的临床疗效。方法回顾性分析应城市人民医院骨科自2012年2月至2015年2月应用改良髋关节前方入路治疗的12例股骨头骨折病人,其中PipkinⅠ型5例、Ⅱ型7例,收集记录手术时间、术中出血量等指标,以及病人骨折愈合、并发症发生情况,采用髋关节Harris评分对病人的功能恢复进行评价。结果手术时间为52.0~85.5 min,平均为67.3 min;术中出血量为150.0~380.0 ml,平均为262.0 ml;住院时间为8~20 d,平均为13 d;随访时间为18~54个月,平均为24个月。所有病人骨折均一期愈合,愈合时间为12~17周,平均为15周,无股骨头坏死、伤口感染、深静脉血栓、异位骨化等并发症。其中1例PipkinⅡ型病人因骨折粉碎较重合并软骨面损伤出现一定程度的创伤性关节炎。根据髋关节Harris疗效评价标准,优9例,良2例,可1例,优良率为91.67%。结论改良髋关节前方入路手术治疗股骨头骨折手术创伤小,对股骨头的血供破坏少,骨折愈合率高,并发症少,髋关节功能恢复良好,适用于PipkinⅠ、Ⅱ型股骨头骨折。 Objective To investigate the clinical effectiveness of modified anterior approach in thetreatment of Pipkin Ⅰ and Ⅱ femoral head fractures.Methods We retrospectively reviewed 12 patients(Pipkin type Ⅰ:5 cases;Pipkin type Ⅱ:7 cases) with femoral head fractures who were treated with modifiedhip anterior approach between February 2012 and February 2015 in the Department of Orthopaedics ofYingcheng People s Hospital.The operative time,bleeding volume,and complications were observed.TheHarris hip score was used to evaluate the functional recovery of patients.Results The operative time was 52.0-85.5 min(mean 67.3 min),and the intraoperative blood loss was 150.0-380.0 ml(mean 262 ml).The length ofhospital stay was 8-20 days(mean 13 days).The patients were followed up for 18-54 months(mean 24 months).All the fractures were primary healed in 12-17 weeks(mean 15 weeks).No obvious necrosis of femoral head,wound infection,deep vein thrombosis occurred.One of the patients with type Pipkin type Ⅱ had a certaindegree of traumatic arthritis due to the comminuted fracture.According to the hip Harris scores,9 casesobtained excellent effect,2 cases good,and 1 cases fair,with the excellent and good rate being 91.67%.Conclusion Modified hip anterior approach would have less damage to the blood supply of the femoral head,higher fracture healing rate,less complications,and could be suitable for Pipkin type Ⅰ and Ⅱ femoral headfractures.
作者 樊政炎 罗政强 FAN Zhengyan;LUO Zhengqiang;Department of Orthopaedics,People's Hospital of Yingcheng;
出处 《骨科》 CAS 2017年第3期223-226,243共5页 Central China Medical Journal
关键词 股骨头 骨折 骨折固定术 手术入路 Femur head Fractures,bone Fracture fixation,internal Surgical approach
作者简介 通信作者:罗政强,E-mail:laoaluo@aliyun.com
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