摘要
股骨颈骨折是临床上的常见损伤。其中,PauwelsⅢ型股骨颈骨折又称为不稳定型股骨颈骨折,骨折端产生的剪切力及内翻应力是导致内固定失效、骨折不愈合的主要原因。除传统三枚空心螺钉固定外,有多种方法增强骨折断端固定强度,包括:三枚空心加压螺钉(CCS)结合一枚横行螺钉(Pauwels螺钉)、动力髋螺钉(DHS)结合一枚防旋转螺钉(DS)、三枚空心螺钉结合内侧支撑钢板、股骨近端经皮加压钢板(PCCP)以及InterTAN髓内钉等。本文对不稳定型股骨颈骨折内固定的生物力学特点、临床疗效、优缺点以及术后股骨头坏死、骨折不愈合的治疗作一综述,旨在为临床治疗不稳定型股骨颈骨折提供参考。
Femoral neck fractures are a common injury in clinic.Pauwels'typeⅢfemoral neck fractures have special biomechanical characteristic,and was known as unstable femoral neck fractures.The main reason of internal fixation failure and nonunion are shear force and varus stress generated between the fracture interfaces.There are various methods of internal fixation to treat unstable femoral neck fractures except to use traditional three cannulated compression screws(CCS),including three cannulated compression screws(CCS)combined with one transverse screw,dynamic hip screw(DHS)combined with de-rotational screw(DS),three cannulated compression screws combined with medial buttress plate,percutaneous compression plate(PCCP)and InterTAN intramedullary nail.Which were reviewed including the biomechanical characteristics,advantages and disadvantages of unstable femoral neck fracture internal fixation,the treatment of nonunion and osteonecrosis of femoral head(ONFH)after surgery,and providing a reference for clinical treatment of unstable femoral neck fractures.
作者
凡兵
高仕长
FAN Bing;GAO Shi-chang(Department of Orthopedics,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042,China)
出处
《中国当代医药》
2020年第14期34-39,共6页
China Modern Medicine
关键词
不稳定型股骨颈骨折
Pauwels分型
内固定治疗
并发症
Unstable femoral neck fracture
Pauwels'classification
Treatment of internal fixation
Complications
