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find Keyword "青壮年" 12 results
  • 空心加压螺钉联合带旋髂深血管骨瓣治疗青壮年股骨颈骨折

    目的总结空心加压螺钉联合带旋髂深血管骨瓣治疗青壮年股骨颈骨折的疗效。 方法2005年8 月-2011年2月,收治13例青壮年股骨颈骨折患者。男8例,女5例;年龄18~46岁,平均34.5岁。致伤原因:交通事故伤9例,高处坠落伤3例,跌伤1例。受伤至手术时间1~10 d,平均3.5 d。根据Garden分型标准分型,Ⅲ型5例,Ⅳ型8 例。采用空心加压螺钉固定联合带旋髂深血管骨瓣移植治疗。 结果除1例患者术中发现血管变异改用缝匠肌肌骨瓣移植外,其余患者均顺利完成手术。术后切口均Ⅰ期愈合,无相关并发症发生。13例均获随访,随访时间18~52个月,平均33.5个月。12例联合带旋髂深血管骨瓣移植者均达骨性愈合,愈合时间3.0~4.5个月,平均3.5个月;无股骨头缺血性坏死发生;术后18个月Harris 评分89~100分,平均96分。1例联合缝匠肌肌骨瓣移植者术后9个月复查示股骨头缺血性坏死并进行性加重。 结论对于青壮年股骨颈骨折,应用空心加压螺钉固定联合带旋髂深血管骨瓣移植重建血运,能促进骨折愈合,减少股骨颈缺血性坏死几率,是一种有效的治疗方法。

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • 空心钉锁定钢板治疗青壮年股骨颈骨折近期疗效

    目的 总结空心钉锁定钢板治疗青壮年股骨颈骨折的近期疗效。 方法2009年2月-2011年5月采用牵引复位、空心钉锁定钢板内固定术治疗23例青壮年股骨颈骨折患者。男15例,女8例;年龄17~54岁,平均32.2岁。骨折分型:股骨颈头下型8例,经颈型10例,基底型5例;GardenⅠ型2例,Ⅱ型4例,Ⅲ型9例,Ⅳ型8例。 结果术后患者切口均Ⅰ期愈合。23例均获随访,随访时间12~32个月,平均18.3个月。1例于术后6个月复查见骨折不愈合并股骨头缺血性坏死关节面塌陷,行人工全髋关节置换术;其余患者均获骨性愈合,愈合时间6~11个月,平均9.1个月。未出现内固定物松动、断裂等并发症。术后6个月Harris评分为(89.39 ± 6.29)分,与术前(40.83 ± 9.07)分比较差异有统计学意义(t=17.38,P=0.00)。 结论空心钉锁定钢板具有固定可靠、退钉率低、骨折愈合率较高等优势,是治疗青壮年股骨颈骨折的一种有效方法。

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • 三枚空心钉与动力髋螺钉结合空心钉治疗青壮年股骨颈骨折的比较研究

    目的 比较3 枚空心钉及动力髋螺钉(dynamic hip screw,DHS)结合空心钉治疗青壮年股骨颈骨折的临床疗效。 方法 2007 年10 月- 2009 年1 月,收治72 例青壮年股骨颈骨折患者。其中40 例采用3 枚空心钉固定(空心钉组):男21 例,女19 例;年龄20 ~ 50 岁,平均35.2 岁。车祸伤8 例,摔伤32 例。受伤至手术时间1 ~ 4 d,平均 2.7 d。32 例采用DHS 结合空心钉固定(结合组):男18 例,女14 例;年龄20 ~ 46 岁,平均37.4 岁。车祸伤6 例,摔伤26 例。受伤至手术时间1 ~ 4 d,平均2.5 d。两组患者一般资料比较,差异无统计学意义(P gt; 0.05),具有可比性。 结果 术后两组切口均Ⅰ期愈合。患者均获随访,随访时间12 ~ 26 个月,平均18.6 个月。空心钉组骨折愈合率为90%(36/40),结合组为100%(32/32);空心钉组股骨头坏死率为10.0%(4/40),结合组为9.4%(3/32)。末次随访髋关节功能按Harris 评分标准进行评价,空心钉组(85.2 ± 4.3)分,结合组(87.4 ± 3.9)分。以上指标两组比较差异均无统计学意义(P gt; 0.05)。 结论 采用3 枚空心钉或DHS 结合空心钉固定治疗青壮年股骨颈骨折均可获得较好疗效。

    Release date:2016-08-31 05:49 Export PDF Favorites Scan
  • 空心钉内固定加股直肌骨瓣移植治疗青壮年股骨颈骨折23 例

    探讨一种治疗青壮年股骨颈骨折的方法。 方法 2000 年5 月- 2005 年10 月,采用空心钉内固定加股直肌骨瓣治疗青壮年股骨颈骨折23 例。男16 例,女7 例;年龄21 ~ 45 岁,平均31.3 岁。车祸伤18 例,高处坠落伤5 例。左侧10 例,右侧13 例。骨折部位:头下型10 例,头下经颈型13 例。Garden 分型:Ⅲ型15 例,Ⅳ型8 例。 结 果 23 例患者术后获随访16 ~ 52 个月,平均26 个月。术后无感染、退钉、骨瓣松动等发生。22 例术后4 ~ 6 个月X 线片示骨折愈合;1 例术后8 个月X 线片示骨折未愈合,术后16 个月CT 及ECT 示股骨头坏死。髋关节功能按Harris 评分标准:优13 例,良8 例,差2 例,优良率91%。 结论 空心钉内固定加股直肌骨瓣移植能有效减少青壮年股骨颈骨折的骨折不愈合和股骨头坏死的几率。

    Release date:2016-09-01 09:12 Export PDF Favorites Scan
  • TREATING AVASCULAR NECROSIS OF FEMORAL HEAD IN YOUNG ADULT BY GRAFTING SARTORIUSMUSCLE ILIAC BONE FLAP

    Objective To explore an improved method of treating avascular necrosis of the femoral head in young adults by grafting the sartorius muscle iliac bone flap. Methods From September 1994 to August 2003, 68 patients (57 males, 11 females; age, 16-58 years) underwent of the transplant the sartorius muscle oliac bone flap into the femoral head after decompression of the femoral head medullary core and removal of the dead bone and the fibrous tissue in the femoral head. The transplantation was performed on 31 patients left-unilaterally, on 37 patients rightunilaterally, and on 7 patients bilaterally. The pathological causeswere as follows: alcoholism in 52 patients, prolonged use of hormones in 6, traumain the hip in 6, and undetermined cause in 4. Their illness course ranged from 8 months to 4 years. According the Ficat staging, 10 patients belonged to Stage I (11 sides), 27 patients to Stage Ⅱ (31 sides), and31 patients to Stage Ⅲ (33 sides). Results The follow-up of the 68 patientsfor 2.5-11 years averaged 5.2 years revealed that based on the Harris evaluation for the hip function, 23 patients had an excellent result, 33 had a good result, 10 had a fair result, and 2 had a poor result. The excellent and good resultsaccounted for 82.3%. There was no recurrence after operation. Conclusion Thismethod has the following advantages: the lesion focus can be eradicated; enoughdecompression can be achieved, and the blood circulation for the femoral head can be rebuilt. The grafting of the sartorius muscle iliac bone flap can bring the osteogenesis components to the femoral head, promoting the reconstruction of the bones. This method is suitable and effective for the patients with avascular necrosis of the femoral head (Ficat Grades Ⅰ, Ⅱ and Ⅲ) in young adults. 

    Release date:2016-09-01 09:23 Export PDF Favorites Scan
  • EFFECTIVENESS OF U-SHAPE TITANIUM SCREW-ROD FIXATION SYSTEM WITH BONE AUTOGRAFTING FOR LUMBAR SPONDYLOLYSIS OF YOUNG ADULTS

    ObjectiveTo investigate the effectiveness of U-shape titanium screw-rod fixation system with bone autografting for lumbar spondylolysis of young adults. MethodsBetween January 2008 and December 2011, 32 patients with lumbar spondylolysis underwent U-shape titanium screw-rod fixation system with bone autografting. All patients were male with an average age of 22 years (range, 19-32 years). The disease duration ranged from 3 to 24 months (mean, 14 months). L3 was involved in spondylolysis in 2 cases, L4 in 10 cases, and L5 in 20 cases. The preoperative visual analogue scale (VAS) and Oswestry disability index (ODI) scores were 8.0±1.1 and 75.3±11.2, respectively. ResultsThe operation time was 80-120 minutes (mean, 85 minutes), and the blood loss was 150-250 mL (mean, 210 mL). Primary healing of incision was obtained in all patients without complications of infection and nerve symptom. Thirty-two patients were followed up 12-24 months (mean, 14 months). Low back pain was significantly alleviated after operation. The VAS and ODI scores at 3 months after operation were 1.0±0.5 and 17.6±3.4, respectively, showing significant differences when compared with preoperative ones (t=30.523,P=0.000;t=45.312,P=0.000). X-ray films and CT showed bone fusion in the area of isthmus defects, with the bone fusion time of 6-12 months (mean, 9 months). During follow-up, no secondary lumbar spondyloly, adjacent segment degeneration, or loosening or breaking of internal fixator was found. ConclusionThe U-shape titanium screw-rod fixation system with bone autografting is a reliable treatment for lumbar spondylolysis of young adults because of a high fusion rate, minimal invasive, and maximum retention of lumbar range of motion.

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  • Research progress of medial buttress plate assisted fixation for femoral neck fractures in young adults

    ObjectiveTo summarize the research progress of medial buttress plate assisted fixation for femoral neck fractures in young adults.MethodsThe literature about buttress plate assisted fixation for femoral neck fractures in young adults was widely reviewed and analyzed. The design principle, background, biomechanical characteristics, and clinical results of buttress plate were summarized.ResultsMedial buttress plate assisted fixation is the latest treatment of femoral neck fractures in young adults, which can convert the shear force at the fracture sides into compression force and promote fracture healing. Medial buttress plate can improve the biomechanical stability of femoral neck fractures and reduce the maximum stress of fixation implants. In clinical, the medial buttress plate can maintain fracture reduction, reduce the incidences of nonunion and surgical failure, and improve hip joint function.ConclusionMedial buttress plate assisted fixation can achieve good effectiveness for femoral neck fractures in young adults. However, due to the preliminary application, its indications, fixation implants, and long-term effectiveness need to be further studied and improved.

    Release date:2020-11-27 06:47 Export PDF Favorites Scan
  • Comparison of effectiveness of two cannulated screw configurations in the treatment of femoral neck fractures in young adults

    ObjectiveTo investigate and analyze the effectiveness of internal fixation with the two different cannulated screw implanting methods of rhomboid and inverted triangle in the treatment of femoral neck fracture in young adults.MethodsThe clinical data of 38 young adults with femoral neck fracture who met the selection criteria between January 2018 and August 2019 were retrospectively analyzed. According to the different methods of cannulated screw implanting, the patients were divided into two groups, 19 cases in each group. The trial group was treated with closed reduction and cannulated screw rhombic distribution internal fixation, while the control group was treated with closed reduction and cannulated screw inverted triangular distribution internal fixation. There was no significant differences in patients’ gender, age, cause of injury, Garden classification of fracture, and time from injury to operation between the two groups (P>0.05). The fracture healing time, the incidence of nonunion, femoral neck shortening, and femoral head necrosis were recorded and compared between the two groups; the effectiveness was evaluated by Harris score and visual analogue scale (VAS) score at last follow-up.ResultsThe incisions of the two groups healed by first intention. All patients were followed up 12-24 months with an average of 15.5 months. There were 1 case of fracture nonunion and 2 cases of shortening of femoral neck in the trial group; while there were 2 cases of fracture nonunion, 1 case of necrosis of femoral head, and 6 cases of femoral neck shortening in the control group; the difference in the incidence of complications (15.8% vs. 47.4%) between the two groups was significant (χ2=4.385, P=0.036). The remaining 18 cases in the trial group and 17 cases in the control group all achieved osteonal union, and the healing time was (14.8±1.6) weeks and (15.9±1.3) weeks, respectively, showing no significant difference between the two groups (t=1.265, P=0.214). At last follow-up, Harris score and VAS score of the trial group were 88.9±4.3 and 1.1±0.7, respectively, while those of the control group were 86.9±5.9 and 1.3±0.9, respectively, showing no significant difference (t=0.603, P=0.550; t=1.152, P=0.257). Hip function was evaluated in accordance with Harris score, the results were excellent in 12 cases, good in 6 cases, and fair in 1 case in the trial group, the excellent and good rate was 94.74%; the results were excellent in 10 cases, good in 7 cases, and fair in 2 cases in the control group, the excellent and good rate was 89.47%; there was no significant difference in the excellent and good rate between the two groups (χ2=0.368, P=0.544).ConclusionThe short-term effectiveness of the two kinds of cannulated screw implanting methods is clear, rhomboid fixation of 4 screws has strong stability with stress distribution, which can effectively reduce the incidence of femoral neck shortening, fracture nonunion, femoral head necrosis, and other complications.

    Release date:2021-03-26 07:36 Export PDF Favorites Scan
  • Effectiveness analysis of medial buttress plate augmented hollow lag screws fixation in combination with sartorius pedicled iliac flap for the treatment of femoral neck fractures in young adults

    Objective To evaluate the effectiveness of medial buttress plate augmented hollow lag screws fixation in combination with sartorius pedicled iliac flap for the treatment of femoral neck fractures in young adults. MethodsThe clinical data of 11 young adult patients with femoral neck fractures between February 2013 and February 2019 were analyzed retrospectively. There were 7 males and 4 females with a mean age of 45 years (range, 32-58 years). Fractures were caused by falling from height in 6 cases, by traffic accident in 4 cases, and by sports injury in 1 case. There were 7 cases in the left hip and 4 cases in the right hip. The mean Pauwels angle was 64° (range, 55°-75°). All patients were treated by medial buttress plate augmented hollow lag screws fixation and sartorius pedicled iliac flap. The X-ray film of pelvis, lateral X-ray film of hip joint, CT scan and three-dimensional reconstruction of hip joint were taken after operation to assess fracture healing and position of the internal fixators. The postoperative hip function was evaluated according to the Harris score. Results All the incisions healed by first intention, and no complication such as incision infection and lateral femoral cutaneous nerve injury happened. Re-examination on the second day after operation showed that reduction and fixation of fractures was good. All patients were followed up 18-36 months (mean, 29 months). All fractures achieved bony union. The time of bony union was 16-23 weeks, with an average of 18.2 weeks. One patient (9.1%) got osteonecrosis of the femoral head (ONFH) at 30 months after operation. At last follow-up, Harris score was used to evaluate hip joint function, 9 cases were excellent, 1 case was good, 1 case was fair, and the excellent and good rate was 90.9%. Conclusion Medial buttress plate augmented hollow lag screws fixation in combination with sartorius pedicled iliac flap for the treatment of femoral neck fractures in young adults has the advantage of strong biomechanical stability and can effectively improve the blood supply of femoral head and neck, which subsequently reduce the incidence of ONFH. However, the surgical indication should be fully considered.

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  • Characteristics of femoral neck fractures in young and middle-aged adults based on fracture mapping technology

    Objective To analyze the characteristics of femoral neck fractures in young and middle-aged adults by means of medical image analysis and fracture mapping technology to provide reference for fracture treatment. Methods A clinical data of 159 young and middle-aged patients with femoral neck fractures who were admitted between December 2018 and July 2019 was analyzed. Among them, 99 patients were male and 60 were female. The age ranged from 18 to 60 years, with an average age of 47.9 years. There were 77 cases of left femoral neck fractures and 82 cases of right sides. Based on preoperative X-ray film and CT, the fracture morphology was observed and classified according to the Garden classification standard and Pauwels’ angle, respectively. Mimics19.0 software was used to reconstruct the three-dimensional models of femoral neck fracture, measure the angle between the fracture plane and the sagittal plane of the human body, and observe whether there was any defect at the fracture end and its position on the fracture surface. Through reconstruction, virtual reduction, and image overlay, the fracture map was established to observe the fracture line and distribution. Results According to Garden classification standard, there were 6 cases of type Ⅰ, 61 cases of type Ⅱ, 54 cases of type Ⅲ, and 38 cases of type Ⅳ. According to the Pauwels’ angle, there were 12 cases of abduction type, 78 cases of intermediate type, and 69 cases of adduction type. The angle between fracture plane and sagittal plane of the human body ranged from –39° to +30°. Most of them were Garden type Ⅱ, Ⅳ and Pauwels intermediate type. The fracture blocks were mainly in the form of a triangle with a long base and mainly distributed below the femoral head and neck junction area. Twenty-six cases (16.35%) were complicated with bone defects, which were mostly found in Garden type Ⅲ, Ⅳ, and Pauwels intermediate type, located at the back of femoral neck and mostly involved 2-4 quadrants. The fracture map showed that the fracture line of the femoral neck was distributed annularly along the femoral head and neck junction. The fracture line was dense above the femoral neck and scattered below, involving the femoral calcar. Conclusion The proportion of displaced fractures (Garden type Ⅲ, Ⅳ) and unstable fractures (Pauwels intermediate type, adduction type) is high in femoral neck fractures in young and middle-aged adults, and comminuted fractures and bone defects further increase the difficulty of treatment. In clinical practice, it is necessary to choose treatment plan according to fracture characteristics. Anatomic reduction and effective fixation are the primary principles for the treatment of femoral neck fracture in young and middle-aged adults.

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