west china medical publishers
Keyword
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Keyword "股骨颈" 110 results
  • 带旋髂深血管束髂骨骨膜移植治疗中青年股骨颈骨折

    Release date: Export PDF Favorites Scan
  • 人工双极股骨头置换术治疗老年股骨颈骨折

    【摘要】目的观察人工双极股骨头置换术治疗老年股骨颈骨折的临床疗效。方法2004年4月2007年10月,采用人工双极股骨头置换术治疗21例老年股骨颈骨折。男8例,女13例;年龄68~80岁,平均年龄726岁。致伤原因:摔伤16例,车祸伤5例。骨折类型:头下型11例,经颈型8例,基底型2例。合并骨质疏松17例,内科疾病31例。伤后至入院时间2~22 h,平均16 h。结果平均手术时间70 min,平均输血量300 mL,手术后引流量平均40 mL。手术后切口均I期愈合。并发尿路感染3例,肺部感染1例,均经抗生素治疗后痊愈。21例均获随访,随访时间6个月~4年,平均28年。X线片检查示髋关节间隙正常。末次随访时按Harris评分标准评定髋关节功能:优14例,良5例,可1例,差1例,优良率90%。结论人工双极股骨头置换术治疗老年股骨颈骨折具有能及时解除患者疼痛、恢复关节功能、防止并发症等优点。

    Release date:2016-09-08 09:45 Export PDF Favorites Scan
  • TREATMENT OF FEMORAL NECK FRACTURE WITH CANNULATED SCREW FIXATION IN YOUNG ADULTS

    Objective To evaluate the clinical effect of cannulatedscrew on treatment of femoral neck fracture(FNF). Methods Forty-two FNFpatients were treated by using cannulated screw from January 2001 to December 2005.There were 22males and 20 females with an average age of 41 years (19-59 years). Fracture was caused by traffic accident in 21 cases, by falling from height in 14 cases and by bruise in 7 cases. All cases were fresh fracture. According to Garden criterion for typing, 15 cases were classified as type Ⅱ, 16 cases as type Ⅲ and 11 cases as type Ⅳ . It was 7 hours to 15 days from injury to operation. Results Thepatients were followed up for 1-6 years with an average of 2.5 years. The average fracture union time was 6.5 months. Three patients had ischemic necrosis of femoral head, andloosening and breakage of screw and rob was observed in 1 case. According to Brumback criterion for hip joint function, the result was excellent in 18 cases, good in 20 cases and bad in 4 cases, and the excellent and good rate was 90.4%. Conclusion Cannulated screw fixation is a good method to treat FNF in young adults. It can improve the rate of fracture union and reduce the rate of avascular necrosis of femoral head.

    Release date:2016-09-01 09:22 Export PDF Favorites Scan
  • COMPARISON OF CANNULATED SCREWS FIXATION WITH DIFFERENT REDUCTION METHODS AT DIFFERENT TIME POINTS FOR DISPLACED FEMORAL NECK FRACTURES IN TERMS OF FRACTURE HEALING

    Objective To compare the therapeutic effect of cannulated screws fixation at different time points through different reduction methods on the heal ing of displaced femoral neck fractures. Methods From January 1997 to September 2007, 240 patients with displaced femoral neck fracture were treated, including 121 males and 119 females aged 22-79 years old (average 56 years old). All cases were fresh and close fractures. According to the fractured part, there were 133cases of subcapital fracture, 64 of transcervical fracture and 43 of basal fracture. According to Garden classification, there were 105 cases of type III and 135 of type IV. Cannulated screws fixation was performed on all the patients, and the time from injury to operation was 6 hours to 7 days. Fifty-five cases received closed reduction and 59 cases received l imited open reduction as emergency treatment, while 65 cases received closed reduction and 61 cases received l imited open reduction as selective operation. Different groups were compared in terms of the heal ing rate of fracture, the excellent and good rate of reduction as well as the excellent and good rate of fixation. Results There was no significant difference between the closed reduction and the l imited open reduction in terms of operation time and bleeding volume (P gt; 0.05). Postoperatively, all wounds healed by first intention, no infection was observed, avascular necrosis of femoral head occurred in 44 cases, and the rate of avascular necrosis of femoral head in the l imited open reduction at emergency group was less than that of other 3 groups (P lt; 0.01). All the patients were followed up for 12-72 months (average 38 months), 193 cases got fracture heal ing at 10-23 months after operation (average 14 months). For the closed reduction as emergency operation group, the l imited open reduction as emergency operation group, the closed reduction as selective operation group, and the l imited open reduction as selective operation group, the heal ing rate of fracture was 74.55%, 91.53%, 69.23% and 86.89%, respectively; the excellent and good rate of reduction was 73.73%, 94.92%,70.77% and 91.80%, respectively; the excellent and good rate of fixation was 76.36%, 93.22%, 73.85% and 88.52%, respectively. The heal ing rate of fracture, the excellent and good rate of reduction as well as the excellent and good rate of fixation in the l imited open groups were higher than that of the closed reduction groups (Plt; 0.01), and there was no significant difference between the emergency operation groups and the selective operational groups (Pgt; 0.05). Conclusion The reduction methods have significant influences on the heal ing of fractures after cannulated screws fixation of the displaced femoral neck fracture, and the operation time has no obvious effect on fracture heal ing.

    Release date:2016-09-01 09:05 Export PDF Favorites Scan
  • 带旋髂深血管蒂髂骨及髂骨膜瓣移位治疗中青年股骨颈骨折

    目的 总结带旋髂深血管蒂髂骨及髂骨膜瓣移位治疗中青年股骨颈骨折的手术方法及临床疗效。 方法 2003 年4 月- 2007 年3 月,收治22 例中青年股骨颈骨折患者。男12 例,女10 例;年龄25 ~ 53 岁,平均42 岁。均为闭合性骨折。致伤原因:交通事故伤18 例,高处坠落伤4 例。受伤至手术时间5 h ~ 43 d。新鲜骨折20 例,陈旧性骨折2 例。骨折部位分型:头下型10 例,经颈型12 例。骨折Garden 分型:Ⅲ型6 例,Ⅳ型16 例。术前Harris 髋关节功能评分(22.80 ± 8.75)分。采用带旋髂深血管蒂髂骨及髂骨膜瓣移位加空心加压螺钉治疗。 结果 术后1 例供区伤口伴液化渗出,经换药治愈;其余切口均Ⅰ期愈合。术后患者均获随访,随访时间20 ~ 60 个月,平均42 个月。21 例股骨颈骨折愈合,愈合时间3 ~ 6 个月,平均3.5 个月;1 例骨折不愈合并股骨头缺血性坏死,于术后6 个月行人工全髋关节置换术。术后14 个月Harris 评分为(86.40 ± 7.95)分,与术前比较差异有统计学意义(P lt; 0.05)。 结论 带旋髂深血管蒂髂骨及髂骨膜瓣治疗中青年股骨颈骨折可改善骨折端血运,促进骨折愈合,减少股骨头坏死的发生。

    Release date:2016-09-01 09:06 Export PDF Favorites Scan
  • 股骨干骨折合并同侧股骨颈骨折八例

    为了总结股骨干骨折合并同侧股骨颈骨折的经验教训,报道8例患者的诊治经过,并提出在高能量损伤时应注意的问题。本组均为高能量创伤所致。股骨颈骨折为基底部无移位性;股骨干骨折为粉碎性,7例位于中段,1例位于上段。一次手术同时切开复位内固定治疗7例,骨牵引治疗1例。平均随访3年,手术复位除1例股骨干骨折未愈合,再次手术外,7例均满意愈合,功能良好。认为对有股骨干骨折的患者,均应提高警惕,注意有无股骨颈合并损伤。一旦确诊,应尽早手术治疗,手术方式以两处骨折分别切开复位内固定为宜。

    Release date:2016-09-01 11:10 Export PDF Favorites Scan
  • ARTIFICIAL TOTAL HIP ARTHROPLASTY WITH COLLUM FEMORIS PRESERVING FOR TREATING HIP JOINT DISEASE IN YOUNG AND MIDDLE-AGED PATIENTS

    Objective To evaluate the therapeutic outcome of artificial total hip arthroplasty (THA) with collum femoris preserving for hip joint desease in young and middle-aged patients. Methods From March 2002 to March 2005, 26 cases (31 hips) of hip joint disease were treated with artificial THA with collum femoris preserving, including 19 males (23 hips)and 7 females (8 hips) and aged 32-48 years with an average of 37 years. In 31 hips, 17 left hips and 14 right hips were involved. There were 9 cases of osteoarthritis of the hip joint caused by avascular necrosis of the femoral head (ANFH), 7 cases of ANFH, 3 cases of femoral head necrosis caused by dysplasia of acetabular, 1 case of osteoarthritis of the hip joint caused by ankylosing spondyl itis, and 2 cases of rheumatoid arthritis; the course of disease was 2-11 years (5.6 years on average). Two cases of femoral neck fracture (Garden IV), and 2 cases of non-union femoral neck fractures (1 for Garden III and 1 for Garden IV), the course of disease was 5 days, 24 months, and 26 months. The prime symptoms were pain, difficult walk and l imp. All patients were taken X-ray to exclude osteoporosis. Results The right distal femur prosthesis of a bilateral patient cracked owing to excessive amputation of collum femoris, and fracture healed after symptomatic treatment. All the incisions healed by first intention and no compl ications occurred. All patients were followed up for 4-7 years, with an average of 5.6 years. One case had poor hip function because he did not follow rehabil itation procedure, and the others achieved good outcome with normal gait. One case complained of persistent pain 6 months after operation, and was rel ieved by administration of some non-steroidal antiinflammatory drugs and anti-osteoporosis drugs 6 months later. The X-ray films after operation and at last follow up showed good location of prosthesis and no bone resorption. Harris score at last follow-up was 91.31 ± 0.77, and it was significantly higher than that before operation (50.88 ± 0.90), (P lt; 0.05). The excellent and good rate was 93.5% (excellent in 11 hips, good in 18 hips, and fair in 2 hips). Conclusion Artificial THA with collum femoris preserving can retain more bone, be easier for revision, and has an excellent outcome.

    Release date:2016-08-31 05:47 Export PDF Favorites Scan
  • Effectiveness analysis of biplanar vertical fixation and inverted triangle fixation with hollow screw for Pauwels type Ⅲ femoral neck fracture in young and middle-aged patients

    Objective To compare the effectiveness of biplanar vertical fixation and inverted triangle fixation with hollow screw for Pauwels type Ⅲ femoral neck fracture in young and middle-aged patients. Methods The clinical data of 55 young and middle-aged patients with Pauwels type Ⅲ femoral neck fracture between June 2021 and December 2022 was retrospectively analyzed. All patients were treated with closed reduction and internal fixation with hollow screws, 25 cases were treated with biplanar vertical fixation (study group), 30 cases with inverted triangle fixation (control group). There was no significant difference in gender, age, affected side, cause of injury, underlying diseases, and time from injury to operation between the two groups (P>0.05). The operation time, intraoperative blood loss, fluoroscopy times, guide needle puncture times, starting time of weight bearing, time of full weight bearing, time of fracture healing, and complications were recorded and compared between the two groups. The hip joint function was evaluated by Harris score at 1 day, 6 months, 12 months after operation, and at last follow-up, and the pain relief was evaluated by visual analogue scale (VAS) score. The femoral neck shortening was measured on the X-ray film at last follow-up. Results All patients were followed up 12-31 months (mean, 22.0 months), and there was no significant difference in follow-up time between the two groups (P>0.05). The operation time, intraoperative blood loss, and fluoroscopy times in the study group were higher than those in the control group, but the difference was not significant (P>0.05). The guide needle puncture times in the study group was more than that in the control group, and the time of starting weight bearing and the time of full weight bearing in the study group were shorter than those in the control group, the differences were significant (P<0.05). Bony healing was achieved in both groups, and there was no significant difference in fracture healing time between the two groups (P>0.05). No osteonecrosis of the femoral head and incision-related complication was found in the two groups during follow-up, and the femoral neck shortening length in the study group was significantly shorter than that in the control group at last follow-up (P<0.05). There was no significant difference in Harris score between the two groups at 1 day after operation (P>0.05), and the Harris score of the study group was significantly better than that of the control group at other time points (P<0.05); there was no significant difference in VAS score between the two groups at each time point after operation (P>0.05). Conclusion Compared with the inverted triangle fixation, the treatment of Pauwels type Ⅲ femoral neck fracture with biplanar vertical fixation can effectively reduce femoral neck shortening without affecting fracture healing, and improve hip joint function in early stage.

    Release date:2024-08-08 09:03 Export PDF Favorites Scan
  • A METHOD TO AVOID LENGTHENING LOWER LIMBS AFTER TOTAL HIP ARTHROPLASTY IN PATIENTS WITH CONGENITAL SHORT FEMORAL NECK

    【Abstract】 Objective To investigate the method to avoid lengthening lower limbs after total hip arthroplasty in patients with congenital short femoral neck. Methods The clinical data were analyzed retrospectively from 38 patients undergoing unilateral total hip arthroplasty between April 2005 and December 2010. There were 26 males and 12 females, aged 45-78 years (mean, 62.3 years). Among these cases, there were 11 cases of avascular necrosis of the femoral head, 17 cases of hip osteoarthritis, and 10 cases of femoral neck fracture. Before operation, 29 cases had leg length discrepancy; and the shortened length of the legs was 10-24 mm with an average of 14.5 mm by clinical measurement, and was 11-25 mm with an average of 14.7 mm by X-ray film measurement. The Harris score before operation was 44.0 ± 3.6. Results At 1 day after operation, 3 cases had legs lengthening by clinical and X-ray film measurement; limb length difference less than 10 mm was regarded as equal limb length in the other 35 patients (92.1%). All incisions healed by first intention, and no complication of infection or lower limb deep venous thrombosis occurred. In 3 patients who had legs lengthening, 1 patient had abnormal gait and slight limping after increasing heel pad because the lower limb was lengthened by 16 mm, and 2 patients had slight limping. The other patients could walk normally and achieved pain relief of hip. Thirty-six patients were followed up 12-68 months (mean, 43.8 months). The Harris score was 86.7 ± 2.3 after 6 months, showing significant difference (t=3.260, P=0.031) when compared with that before operation. The X-ray films showed no prosthetic loosening or subsidence. Conclusion For patients with congenital short femoral neck during total hip arthroplasty, the surgeons should pay attention to osteotomy plane determination, limb length measurement, and use of the prosthesis with collar to avoid the lengthening lower limbs

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • PEDICLED ILIAC PERIOSTEAL FLAP GRAFT FOR AVASCULAR NECROSIS OF FEMORAL HEAD AFTER FEMORAL NECK FRACTURE IN ADOLESCENTS

    ObjectiveTo assess the effectiveness of pedicled iliac periosteal flap graft for treatment of avascular necrosis of the femoral head (ANFH) after femoral neck fracture in adolescents. MethodsBetween December 2006 and August 2011, 9 patients (9 hips) with ANFH after femoral neck fracture were treated with pedicled iliac periosteal flap graft. There were 6 males and 3 females with an average age of 14.7 years (range, 10-18 years). Fractures were caused by traffic accident injury (5 cases), falling injury from height (3 cases), and fall injury (1 case). The time from injury to internal fixation with Kirschner wires or cannulated screws was 3-16 days, and all fractures healed within 10 months after internal fixation. The interval between fracture fixation and ANFH was 10-42 months (mean, 24.4 months). According to Steinberg staging system, 1 hip was classified as stage Ⅲb, 2 hips as stage Ⅲc, 1 hip as stage IVa, 3 hips as stage IVb, and 2 hips as stage IVc. The Harris scores and Steinberg classification were compared between at pre- and post-operation to assess the outcomes clinically and radiologically. ResultsAll incisions healed by first intention. No complications of infection, deep venous thrombosis of lower limb, and pain and numbness of donor site were observed during or after operation. All patients were followed up 38-76 months (mean, 52 months). Joint pain was relieved; no leg length discrepancy was observed; the walking gait was improved and range of motion of hips was increased. The Harris score was significantly increased from 62.8±3.6 at pre-operation to 92.7±9.9 at last follow-up, showing significant difference (t=-12.244, P=0.000). The hip function was excellent in 5 hips, good in 3 hips, and poor in 1 hip, and the excellent and good rate was 88.89%. Post-operative radiological assessment demonstrated that only 1 hip (stage Ⅲb) had further collapse of the femoral head, the other hips had no incidence of deterioration. The radiological success rate was 88.89% (8/9). ConclusionThe pedicled iliac periosteal flap graft for ANFH after femoral neck fracture in adolescents can provide good osteogenesis and vascular reconstruction of the femoral head.

    Release date: Export PDF Favorites Scan
11 pages Previous 1 2 3 ... 11 Next

Format

Content