發(fā)布時間：2018-03-13 22:43

  本文選題：股骨頸骨折　切入點：切開復(fù)位內(nèi)固定術(shù)　出處：《蘭州大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：本文通過三種手術(shù)方式治療FNF,比較閉合復(fù)位內(nèi)固定、切開復(fù)位內(nèi)固定+關(guān)節(jié)囊減壓、全髖關(guān)節(jié)置換治療FNF的療效。方法：回顧性調(diào)查研究我院收治的老年新鮮FNF213例病例的臨床資料。根據(jù)骨折類型分為非移位組(A組)、移位組(B組)。根據(jù)手術(shù)方式將A組分為閉合復(fù)位內(nèi)固定組(A1)、切開復(fù)位內(nèi)固定+關(guān)節(jié)囊減壓組(A2)、人工關(guān)節(jié)全髖關(guān)節(jié)置換組(A3)；同理將B組分為B1、B2、B3。對所有病例系統(tǒng)追蹤隨訪2年到3年,對術(shù)前、術(shù)中、術(shù)后各項指標(biāo)進(jìn)行全面評價及分析。結(jié)果：A1、A2手術(shù)時間、術(shù)中失血量顯著優(yōu)于A3,術(shù)后部分負(fù)重時間、術(shù)后負(fù)重時間較A3差；B1、B2手術(shù)時間、術(shù)中失血量顯著優(yōu)于B3,術(shù)后部分負(fù)重時間、術(shù)后負(fù)重時間較B3為差：A2術(shù)后髖關(guān)節(jié)Harris評分顯著優(yōu)于A1、A3：B2術(shù)后髖關(guān)節(jié)Harris評分顯著優(yōu)于B1、B3；B2術(shù)后股骨頭缺血性壞死(ANFH)的發(fā)生率顯著優(yōu)于B1。結(jié)論：老年新鮮非移位型FNF,優(yōu)先考慮外傷后6小時到24小時內(nèi)行“FNF切開復(fù)位加壓空心螺釘內(nèi)固定術(shù)+關(guān)節(jié)囊減壓術(shù)”治療。老年新鮮移位型FNF,優(yōu)先考慮行“FNF人工全髖關(guān)節(jié)置換術(shù)”治療。臨床治療老年FNF應(yīng)根據(jù)患者具體情況、手術(shù)適應(yīng)證、患者訴求、手術(shù)者經(jīng)驗綜合考慮慎重選擇治療方案。
[Abstract]:Objective: through three kinds of surgical treatment of FNF, compared with closed reduction and internal fixation, open reduction and internal fixation and joint capsule decompression, the efficacy of FNF in treating hip arthroplasty. Methods: clinical data of FNF213 cases of elderly fresh research in our hospital. According to fracture types are divided into non displaced group (A group), transposition group (group B). According to the operation mode of the A group was divided into internal fixation group (A1), open reduction and internal fixation and joint capsule decompression group (A2), artificial total hip replacement group (A3); in the B group was divided into B1, B2, B3. in all cases followed up 2 to 3 years, preoperative, intraoperative and postoperative indexes of comprehensive evaluation and analysis. Results: A1, A2, operation time, intraoperative blood loss was significantly higher than A3, part time weight after surgery, postoperative weight-bearing time is A3; B1 B2, operation time, blood loss in the operation of the rear is significantly superior to B3. Point load time, postoperative weight-bearing time than B3: A2 postoperative Harris hip score was significantly higher than A1, A3:B2 postoperative Harris hip score was significantly better than that of B1, B3; B2 after operation of femoral head avascular necrosis (ANFH) incidence rate was significantly higher than B1. conclusion: elderly fresh non displaced type FNF, is preferred. 6 hours after trauma to within 24 hours "FNF open reduction and hollow compression screw fixation + capsular decompression treatment. The elderly displaced FNF, priority for FNF total hip arthroplasty treatment. Clinical treatment of elderly patients with FNF should be based on specific conditions, surgical indications, patient demands, surgery considering the experience of carefully chosen treatment.

【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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本文編號：1608483