中华创伤骨科杂志2024,Vol.26Issue(12) :1084-1088.DOI:10.3760/cma.j.cn115530-20240506-00196

骨钩拉扽技术在外展嵌插型股骨颈骨折闭合复位中的应用

Reduction of valeus-impacted femoral neck fractures by bone hook pulling technique

任涛涛 武波 崔玉 张诚诚 王志猛 戚鸿飞 艾先杰 张堃 李忠 李明
中华创伤骨科杂志2024,Vol.26Issue(12) :1084-1088.DOI:10.3760/cma.j.cn115530-20240506-00196

骨钩拉扽技术在外展嵌插型股骨颈骨折闭合复位中的应用

Reduction of valeus-impacted femoral neck fractures by bone hook pulling technique

任涛涛 1武波 2崔玉 2张诚诚 2王志猛 2戚鸿飞 2艾先杰 1张堃 2李忠 2李明2
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作者信息

  • 1. 延安大学医学院,延安 716000;西安交通大学附属红会医院创伤骨科,西安 710054
  • 2. 西安交通大学附属红会医院创伤骨科,西安 710054
  • 折叠

摘要

目的 探讨骨钩拉扽技术在外展嵌插型股骨颈骨折闭合复位中的应用效果.方法 回顾性分析2021年9月至2022年9月期间西安交通大学附属红会医院创伤骨科收治的12例外展嵌插型股骨颈骨折患者资料.男6例,女6例;年龄(43.8±10.1)岁;骨折Garden分型:12例均为Ⅰ型;骨折Pauwels分型:Ⅰ型10例,Ⅱ型2例.所有患者术前经X线片和CT影像明确诊断,术中应用骨钩拉扽技术复位,将骨钩由外侧伸至小转子内侧钩实,向外侧拉扽骨钩,借助拉扽外力及周围软组织铰链的作用复位骨折,然后采用股骨颈动力交叉钉系统固定.记录患者的手术切口长度、骨钩相关操作透视次数、手术时间、骨折复位质量、骨折愈合时间及末次随访时髋关节功能恢复情况和股骨颈短缩情况等.结果 12例外展嵌插型股骨颈骨折患者均通过骨钩拉扽技术成功复位.本组患者的手术切口长度为(4.6±0.7)cm,骨钩相关操作透视次数为(4.3±0.7)次,手术时间为(54.3±4.2)mino12例患者术后获(11.5±4.2)个月随访,骨折愈合时间为(4.2±0.7)个月.术后骨折复位质量根据Garden指数评定:Ⅰ级10例,Ⅱ级2例.末次随访时根据髋关节Harris评分标准评定髋关节功能:优10例,良2例.末次随访时12例患者的股骨颈短缩长度为(1.17±0.68)mm,未见与骨折复位相关的并发症.结论 骨钩拉扽技术复位外展嵌插型股骨颈骨折具有手术操作简单、复位成功率高等优势,临床应用效果满意.

Abstract

Objective To evaluate the bone hook pulling technique in reduction of valgus-impacted femoral neck fractures.Methods A retrospective study was conducted to analyze the clinical data of 12 pa-tients who had been treated from September 2021 to September 2022 for valgus-impacted femoral neck fractures at Department of Orthopaedics and Traumatology,Honghui Hospital.There were 6 males and 6 females with an age of(43.8±10.1)years.By the Garden classification,the 12 cases were all type Ⅰ;by the Pauwels classifica-tion,10 cases were type Ⅰ and 2 cases type Ⅱ.All patients were definitively diagnosed preoperatively by radio-graphs and CT images.The bone hook pulling technique was used to extend the bone hook from the lateral side to the medial side of the lesser trochanter,pull the bone hook to the lateral side,and reset the fracture with the help of pulling force and the action of the surrounding soft tissue hinge.The fractures were then fixed with the Femoral Neck System(FNS).Length of surgical incision,number of fluoroscopy for bone hook-related operations,opera-tion time,quality of fracture reduction,fracture healing time,functional recovery of the hip and shortening of the femoral neck at the last follow-up were recorded.Results The 12 valgus-impacted femoral neck fractures were successfully reset by the hook pulling technique.In this cohort,the length of surgical incision was(4.6±0.7)cm,the number of fluoroscopy for bone hook-related operations(4.3±0.7)times,and the operation time(54.3±4.2)min.The 12 patients were followed up for(11.5±4.2)months postoperatively and the fracture healing time(4.2±0.7)months.According to the Garden score,the quality of postoperative fracture reduction was assessed as grade Ⅰ in 10 cases and as grade Ⅱ in 2 cases.According to the Harris hip score,the hip function was assessed as excellent in 10 cases and as good in 2 cases at the last follow-up.The length of femoral neck shortening was(1.17±0.68)mm at the last follow-up in the 12 patients;no complications related to fracture re-duction were observed.Conclusion In the reduction of valgus-impacted femoral neck fractures,bone hook pulling technique shows advantages of operational simplicity,a high rate of successful reduction,and satisfactory clinical effects.

关键词

股骨颈骨折/骨折固定术,内/骨钉/骨钩/股骨颈动力交叉钉系统/骨折复位/外展嵌插型

Key words

Femoral neck fractures/Fracture fixation,internal/Bone nails/Bone hook/Femoral neck system/Reduction of fracture/Valgus-impacted

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出版年

2024
中华创伤骨科杂志
中华医学会

中华创伤骨科杂志

CSTPCDCSCD北大核心
影响因子:1.579
ISSN:1671-7600
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