股骨颈骨折倒三角空心螺钉内固定时后上方螺钉in-out-in的研究进展
Research into the in-out-in posterosuperior screw in the fixation of femoral neck fractures with inverted triangular cannulated screws
安林 1汤欣 2张健1
作者信息
- 1. 宁波市第六医院创伤骨科,宁波 315040
- 2. 大连医科大学附属第一医院创伤骨科,大连 116011
- 折叠
摘要
股骨颈骨折倒三角空心螺钉内固定时后上方螺钉容易穿出股骨颈皮质后再穿入股骨颈髓腔内导致in-out-in,在传统术中C型臂X线机正、侧位透视中无法准确显示.由于后上方螺钉穿出股骨颈皮质处靠近上支持带动脉,存在潜在的医源性损伤,可能导致术后骨不连、股骨头缺血性坏死的发生风险增加.因此,近年来骨科医生广泛关注后上方空心螺钉in-out-in.本文针对股骨颈骨折倒三角空心螺钉内固定时后上方螺钉in-out-in的发生率、发生原因、对临床预后的影响及如何避免后上方螺钉in-out-in等最新研究结果进行综述.
Abstract
The posterosuperior screw which penetrates the femoral cortex anatomically but not fluoroscop-ically in the fixation with inverted triangular cannulated screws for femoral neck fractures is referred to as the in-out-in screw.It may cause an iatrogenic damage to the superior retinacular artery,leading to an increased inci-dence of nonunion and femoral head necrosis.Therefore,it has drawn extensive attention from orthopedic surgeons in recent years.The present article reviews the latest studies on the incidence and causes of the in-out-in postero-superior screw in the fixation with inverted triangular cannulated screws for femoral neck fractures,analyzes its impact on clinical outcomes,and makes suggestions to keep the the posterosuperior screw from in-out-in.
关键词
股骨颈骨折/骨折固定术,内/骨钉/螺钉穿透Key words
Femoral neck fractures/Fracture fixation,internal/Bone screws/Screw penetration引用本文复制引用
出版年
2024
NETL
NSTL
万方数据