闭合复位经皮空心钉固定治疗青少年股骨颈骨折的临床观察

目的：分析闭合复位经皮空心钉固定治疗青少年股骨颈骨折的临床疗效及影响因素，为青少年股骨颈骨折的手术治疗提供依据。方法：分析36例采用闭合复位经皮空心钉固定手术治疗的青少年股骨颈骨折患者的临床疗效及影响因素。观察患者伤后至手术的时间、X线片评估骨折愈合的时间、髋关节功能Harris评分对术后功能的评估及并发症发生情况。结果：36例患者均获得随访，随访时间6~24个月，平均16个月。36例患者有1例出现股骨头坏死，占全部患者的2.78%；2例骨折不愈合，占全部患者的5.56%。其余33例患者骨折均完全愈合。髋关节功能评分优26例，良6例，中2例，差2例，优良患者构成比88.89%。结论：闭合复位经皮空心钉固定治疗青少年股骨颈骨折是有效的手术方案，合适的手术时机、良好的复位和牢固的内固定可减少股骨头坏死及并发症的发生率。

Clinical observation of closed reduction and percutaneous cannulated screw fixation in treatment of femoral neck fracture in adolescents

Objective:To analyze the clinical effect and influencing factors of closed reduction and percutaneous cannulated screw fixation in the treatment of femoral neck fracture in the adolescents, and to provide evidence for surgical treatment of femoral neck fracture in the adolescents. Methods:The clinical effect and influencing factors of 36 cases of femoral neck fracture treated by closed reduction and percutaneous cannulated screw fixation were analyzed. The time of operation, the time of fracture healing evaluated with X-ray image, the evaluation on the function after operation by Harris score of hip joint,and the occurrence of complications of the patients were observed.Results:All the cases were followed up for 6-24 months, average 16 months. One case of all patients had avascular necrosis of the femoral head, and accounted for 2.78% of all the patients;2 cases of all fractures were nonunion, and 5.56%.The remaining 33 cases were completely healed.The HHS-harris hip score results showed that 26 were excellent, 6 cases were good, and 2 cases were poor;the excellent and good rate was 88.89%.Conclusion:Closed reduction and percutaneous cannulated screw fixation in the treatment of adolescent femoral neck fracture is an effective program of operation;timing of operation, good reduction, and rigid internal fixation can decrease the femoral head necrosis and the incidence of complications.