股骨颈骨折内固定失败Ⅱ期行髋关节置换的早期疗效

目的:研究青壮年股骨颈骨折患者内固定失败后Ⅱ期行髋关节置换的早期临床疗效。方法:2008年6月至2010年6月,对24例股骨颈骨折内固定术后股骨头坏死患者行全髋关节置换术,其中男12例,女12例;年龄18～58岁,平均42.9岁。术后行X线检查,并根据Harris评分标准评价临床疗效。结果:23例获得随访,平均随访时间34.4个月(25～48个月),1例术后并发髋关节脱位,未发现髋关节感染、松动或假体周围骨折等并发症。Harris评分为90.9±4.3,优18例,良4例,可1例。结论:Ⅱ期全髋关节置换治疗股骨颈骨折内固定术后并发股骨头坏死,术中手术难度增加,但可以获得良好的早期疗效。

Evaluation of early clinical results of two stage hip replacement after failed internal fixation for femoral neck fractures

Objective: To evaluate the early clinical results of two stage hip replacement after failed internal fixation for femoral neck fractures in young patients.Methods: From June 2008 to June 2010,24 patients with femoral head necrosis caused by failed internal fixation were treated with hip arthroplasty. Among them,12 patients were male and 12 patients were female,with an average age of 42.9 years old (ranged,18 to 58). According to Harris score and X-ray examination,the clinical resultwas evaluated.Results: Twenty-three cases were followed up with an average age of 34.4 months (ranged,25 to 48). After operation,1 case complicated with the dislocation of hip joint. No deep infection of hip joint,prosthetic loosing or peripheral fracture was found. The mean Harris score was 90.9±4.3,and 18 obtained excellent results,4 good and 1 fair.Conclusion: Although treatment of femoral head necrosis with two stage hip replacement after failed internal fixation is difficult during operation,its early result is satisfactory.