目的 探讨老年股骨颈骨折患者闭合复位经皮空心螺钉术后的预后及并发症。方法 回顾性分析本院经空心加压螺纹钉治疗的老年股骨颈骨折145例,其中GardenⅠ型22例,Ⅱ型 55例,Ⅲ型 52例,Ⅳ型 16例;术后2年随访患者术后并发症,股骨头坏死或骨折不愈合的情况以及患肢功能。结果 术后Garden Ⅰ～Ⅳ型发生骨折不愈合或者缺血性坏死的发生率分别为4.5%、3.6%、15.4%、31.3%。术后并发症的发生率在Garden 分型的四型中差异无统计学意义。结论 闭合复位经皮空心螺钉术对于老年股骨颈骨折患者是一个有效的方法,特别在Garden Ⅰ型和Garden Ⅱ型的患者中应是首选治疗方法。

Objective To evaluate the Results and complications of femoral neck fractures in elderly patients treated with close reduction plus percutaneous cannulated screw fixation. Methods We retrospetively Ⅳely studied 145 patients older than 60 years who presented with femoral neck fractures that underwent cannulated screw fixation between 2003 and 2011. The Results of 145 patients that had 2-year follow-up included postoperative complications and hip joint function which was evaluated according to the Harris score. Garden classification was use for the patients, 22 of whom were typeⅠ, 55 were type Ⅱ, 52 were type Ⅲ, 16 were type Ⅳ. Results The incidences of nonunion or avascular necrosis were 4.5% , 3.6% , 15.4%, and 31.3% in the patients who were classified as Garden Ⅰ, Garden Ⅱ, Garden Ⅲ, and Garden Ⅳ respectively. There were no statistical differences in the rate of postepercativeive complications in the patients with Garden classification. The rate of postepercativeive complications in the patients with ASA Ⅲ was higher than thsse in ASA Ⅰ and ASA Ⅱ. Conclusions Close reduction plus percutaneous cannulated screw fixation is an effectiveive method for treating femoral neck fractures in the patients more than 60 tears old and is a prior method in the patients of Garden Ⅰ and Garden Ⅱ types.