【作者】 周高尚；

【导师】 孔荣；

【作者基本信息】 安徽医科大学 ， 外科学， 2011， 硕士

【摘要】 目的评测股骨颈骨折后股骨头圆韧带动脉血供情况,探讨其临床治疗方法,为可以采用闭合复位内固定保留股骨头治疗股骨颈骨折取得理论依据。方法在70例行人工髋关节置换术中,断头取出后,肉眼直视下观察干净纱布擦拭前后髋臼窝圆韧带动脉的出血情况。术后把切除的圆韧带送检病理,横断圆韧带制作病理切片观察圆韧带动脉通畅情况。结果70例观察对象,干净纱布擦拭前可见圆韧带动脉出血而擦拭后仍有出血共有44例;擦拭前可见圆韧带动脉出血而擦拭后未见出血共有13例;擦拭前后均未见出血13例。术后送检圆韧带行病理切片提示圆韧带动脉通畅38例,不通畅者32例。运用SPASS 18.0软件统计分析,P<0.0167,60岁以下年龄组与另外两组圆韧带动脉通畅情况有差别,有统计学意义。结论综合评估股骨颈骨折后股骨头圆韧带动脉血供情况,60岁以下年龄组股骨颈骨折后患者股骨头圆韧带动脉总体通畅情况良好,Garden III型及以下股骨颈骨折可以行保留股骨头治疗;Garden IV型及60岁以上股骨颈骨折患者建议一期行人工假体置换术。更多还原

【Abstract】 Objective To evaluate the round ligament artery of the femoral head after femoral neck fracture and to discuss the therapy in clinics, and get the theoretical basis for the closed reduction and internal fixation.Methods We observed the round ligament artery bleeding by eye before and after swabbing in 70 cases in the THA. And made the pathological inspection of the round ligament to make the transection of the round ligament and make sure whether the round ligament artery is smooth or not.Results We observed the round ligament artery bleeding by eye in 70 cases in the THA. 44cases of round ligament artery were observed bleeding before and after swabbing.13cases of round ligament artery were observed bleeding before after swabbing. while 13 cases not bleeding after swabbing. 13cases of round ligament artery were not observed bleeding before and after swabbing.38 cases of round ligament artery were smooth while 32 cases of vascular narrow or unseen. Group under 60 years was statistically significant compared with the other two groups, according to the SPSS 18.0 Software (P <0.0167).Conclusion The blood supply of femoral head after femoral neck fracture in the group under the age of 60 is in good condition. We could retain the femoral head of femoral neck fracture in the treating of the Garden I, II, III. Garden IV-type and people above 60 with femoral neck fracture are recommended to take the THA.更多还原