同侧股骨干、股骨颈骨折的手术治疗
股骨颈骨折,股骨颈骨折；股骨干骨折；股骨重建钉；疗效,摘要,关键词,Abstract,Keywords,1资料与方法,2结果,3讨论,参考文献
【摘要】目的 观察两种手术方法治疗同侧股骨干、股骨颈骨折的疗效。
方法 对我院1998年6月～2004年6月收治的35例同侧股骨干、股骨颈骨折的患者进行手术治疗。年龄25～63岁，平均40岁。8例开放性骨折为Gustilo Ⅱ型。20例患者有合并损伤，10例患者累及同侧髌骨。股骨颈骨折按照Garden分型，Ⅱ型20例，Ⅲ型11例，Ⅳ型4例。股骨干骨折按照Winquist分类Ⅰ° 5例，Ⅱ° 10例，Ⅲ° 7例，Ⅳ° 13例。21例患者使用股骨重建钉，14例患者使用空心加压螺钉联合逆行股骨交锁髓内钉。
结果 全部病例随访10～32个月，平均19个月，均获得一期骨性愈合。平均愈合时间分别为：空心加压螺钉联合逆行股骨交锁髓内钉组：股骨颈12周(10～18周)，股骨干16周(12～20周)，一期愈合率93%；股骨重建钉组：股骨颈10周(8～12周)，股骨干14周(12～18周)，一期愈合率96%。远期疗效，按马元璋评定标准：优、良率分别为912%、93.3%。
结论 空心加压螺钉联合逆行股骨交锁髓内钉和股骨重建钉治疗同侧股骨干、股骨颈骨折均可获得满意疗效，但股骨重建钉是目前治疗同侧股骨干、股骨颈骨折的理想方法。
【关键词】 股骨颈骨折；股骨干骨折；股骨重建钉；疗效
Operative treatment of ipsilateral femoral neck and shaft fractures
YU Lian-xiang,ZHANG Hui,WANG Xin-sheng,et al.
Department of Orthopaedics,The Affiliated Hospital of Taishan Medical College,Taian 271000,China
【Abstract】
Objective To explore the two operative methods for ipsilateral femoral neck and shaft fractures.
Methods From June 1998 to June 2004,35 patients who had suffered from ipsilateral femoral neck and shaft fractures were treated with internal fixation devices.The ages of the patients were from 25 to 63 years old (averaging 40 years old).There were 8 open fractures(Gustilo Ⅱ).The incidence of associated injuries was 57.1%(20/35).About one third of the patients were involved in ipsilateral patellar fractures.According to Garden classification for femoral neck fractures,20 cases were graded as Ⅱ,11 Ⅲ,and 4 Ⅳ.All the femoral shaft fractures were classified according to Winquist system:Grade-Ⅰ in 5 cases,Grade-Ⅱ in 10,Grade-Ⅲ in 7,and Grade-Ⅳ in 13.21 of them were stabilized with reconstruction interlocking nail,stabilization of the neck with cannulated screws and the diaphysis with retrograde interlocked nailing was used in the other 14 cases. ......
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