Closed reduction of femoral neck fractures, three

e707004304 · Wysłany: Śro 23:54, 09 Mar 2011

Closed reduction of femoral neck fractures, three headed cannulated screw fixation (39 cases)

erativeSurgery, Nov. 2000, Vol4,[link widoczny dla zalogowanych], No. 41.3 Results after 1 week X-ray review, 39 cases were anatomic reduction or near anatomic reduction (Figure 3,4). The average follow-up time of 25 (6 to 42) months, fractures are not connected in 1 case (2.6%), avascular necrosis in 3 cases (7.7%), the two together accounting for 10.3%. Shen Xia and other light after internal fixation of femoral neck fracture on the functional evaluation criteria ..., excellent in 28 cases (71.8%), good in 7 cases (17.9%) and poor in 4 cases (10.3%). Figure 3 femoral neck fracture fixation of femoral neck fractures prior to Figure 4 after the two discussed the fixed femoral neck fractures are very common, accounting for 5.6%】 body fractures,[link widoczny dla zalogowanych], most occur in the elderly. As human life expectancy increases, the incidence gradually increased. Documented unhealed femoral neck fracture rate of about 15%, avascular necrosis rate of 20% to 30% [Citation. Traction treatment of femoral neck fractures leg longer, especially for the elderly does not seem to pose a major trauma and do not directly treat risks. However, the traction against the muscle contraction is mainly produced in the fracture between the shear, it is difficult to achieve satisfactory reduction and fixation can not play immediately, it is not conducive to fracture healing】. Prosthetic replacement has been widely used despite the treatment of femoral neck fractures, but the patient's age, the life of prosthesis and possible complications arising from the application of constrained prosthesis. If we can keep their own through the fixation of the femoral head is the best way to】. Therefore, to explore methods of femoral neck fractures is still an important subject of clinical orthopedic research. . Closed reduction and internal fixation for displaced femoral neck fractures in most cases the body can not tolerate or hemiarthroplasty, or unwilling to make those】 hemiarthroplasty. Fixation of femoral neck fracture fracture of the key is to maintain a good state of the effective fixed position. Mainly to solve the mechanical problem is to prevent rotation between the ends of the bones, separation and dislocation of the upper and lower shear. Three-blade nail is first used in fixation of femoral neck fracture devices,[link widoczny dla zalogowanych], their morphology,[link widoczny dla zalogowanych], have a certain role in anti-rotation, but not against the top of the femoral neck fracture tensile stress easily understood result in the separation between, it is difficult against the muscle contraction or the upper and lower limbs generated when the shear load, which has displaced femoral neck fractures on the failure rate of almost 50%, 30% rate of nonunion, femoral head necrosis rate of 21% or more, it has been very little clinical on the application. Multi-headed nail or compression screw Dengjun single edge in the three improvements based on the nail, but not effectively take into account the anti-rotation and anti-separation, making it difficult to maintain fracture stability of a good reset. Nail plate (such as Richard'S nails,[link widoczny dla zalogowanych], etc.) have greater fixation strength, but also increase the surgical trauma. Three double-headed cannulated screw fixation of femoral neck fracture, three nails through the Ministry of fractures in the femoral neck cross section composed of a stable three nails plane geometry, can effectively prevent rotation between the fracture dislocation. Double compression screw the two ends of the structure was mostly rough, when the screw head with a fracture line across the femoral neck into the femoral head, to continue to tighten the pressure generated when the role of the fracture of the joint between the closely to prevent the separation, is conducive to healing. Because of three screws in the reasonable distribution of head and neck, located at the top of the neck at the top of screws enhances the tensile stress, effectively prevent fractures of the upper part of the separation, to avoid the occurrence of varus; located close to the bottom of the femur through the femoral head from hard within the femur with screws from a fulcrum below the greater trochanter and cortical bone at the end of the joint action of nails have a strong leverage against the fracture between the upper and lower shear force, make it more solid fixation of femoral neck fracture . The procedure is simple, minimally invasive, curative effect satisfaction, it is worth promoting. 【
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