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1、股骨干骨折合并同側(cè)股骨頸骨折的手術(shù)治療方法及臨床療效【摘要】目的:觀察并分析股骨干骨折合并同側(cè)股骨頸骨折的手術(shù)治療方法及臨床療效。方法:回顧性分析2012年1月-2015年2月筆者所在醫(yī)院收治的50例股骨干骨折合并同側(cè)股骨頸骨折的患者,44例在手術(shù)前診斷為股骨干骨折合并同側(cè)股骨頸骨折,其中采用股骨髓內(nèi)釘重建同時固定股骨頸骨折和股骨骨干骨折有32例,采用鋼板固定股骨干骨折、空心螺釘固定股骨頸骨折有12例;有3例在手術(shù)前只診斷了股骨干骨折而漏診了股骨頸骨折,手術(shù)采用髓內(nèi)釘進行固定,手術(shù)后發(fā)現(xiàn)合并患有股骨頸骨折,2
2、例采用空心螺釘加以治療,4例采取重建髓內(nèi)釘?shù)闹委煼椒?。結(jié)果:對術(shù)后患者進行隨訪,時間為1?4年,平均1.4年。48例患者的骨折在術(shù)后15?31周愈合,平均時間為19周;2例患者股骨干骨折在術(shù)后1年仍沒有愈合,進行再次植骨手術(shù)后24周愈合;25例患者均沒有發(fā)生股骨頭壞死。結(jié)論:采用手術(shù)治療股骨干骨折合并同側(cè)股骨頸骨折時,只要嚴(yán)格按照操作規(guī)范并選用合適的固定材料,都可以獲得較好的治療效果?!娟P(guān)鍵詞】股骨干骨折;股骨頸骨折;手術(shù)治中圖分類號R687.3文獻標(biāo)識碼B文章編號1674-6805(2015)23-0062
3、-02SurgicalTreatmentforIpsilateralFracturesofFemoralNeckandShaft/LINShi-fu,PANFu-wen,WANGQi-qi,etal.//ChineseandForeignMedicalResearch,2015,13(23):62-63【Abstract】Objective:Toobserveandexploretheeffectofsurgicaltreatmentonpatientswithipsilateralfemoralneckan
4、dshaftfractures.Method:Aretrospectivestudyof50caseswithipsilateralfemoralneckandshaftfracturesfromJanuary2012toFebruary2015wasdone.Amongthe44caseswhowereclearlydiagnosedbeforeoperation,32casesweregivenreconstructionnailingofbothshaftandneck,12casesweregiven
5、cancellousscrewfixationfortheneckandlimitedcontactdynamiccompressionplate(LC-DCP)fixationfortheshaft.Bothofthe6caseswhoweremisdiagnosedbeforethefirstoperationwerefixedwithintrameduiiarynailoriginally.Afteripsilateralfemoralneckfracturewasdiagnosed,secondope
6、rationsweredonetothem.Twocaseswasfixedwithcancellousscrew,4caseswasfixedwithreconstructionnail.Result:Allcaseshavebeenfollowedupfor1to4years(withanaverageof1.4years).Thefemoralshaftfractureswerehealedat15?31weeks(withanaverageof19weeks)afteroperationin48cas
7、es.Thefemoralshaftfracturesfailedtohealin2casesevenat1yearaftertheoperation,andafterbonegrafting,thepatientwashealed24weekslater.Femoralheadnecrosisdidnotoccurinanycases.Conclusion:Satisfactoryclinicaleffectcanbeachievedthroughrationalandreliableinternalfix
8、ationinipsilateralfemoralshaftandneckfractures.【Keywords】Femoralshaftfractures;Femoralneckfractures;SurgicaltreatmentFirst-author'saddress:HainanProvinceNongkenSanyaHospital,Sanya572000,Chinadoi:10.140