经骨隧道关节镜下股骨颈断裂克氏针取出的临床应用
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中国人民解放军联勤保障部队第910医院

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Retrieval of broken wire in femoral neck with bone endoscopy
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the 910th hospital of PLA

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    摘要:

    目的:探讨经骨隧道关节镜下股骨颈断裂克氏针取出的临床疗效。方法:2011年3月至2020年5月我院骨科共收治股骨颈克氏针断裂7例,其中,男2例,女5例;年龄32~67岁,平均(48.3±6.0)岁。左侧1例,右侧6例。克氏针断裂位置:股骨颈内1例,股骨头内5例,穿破股骨头1例。新鲜断裂6例,陈旧断裂1例。断裂原因:克氏针自身原因断裂1例,钻头切割断裂3例,螺钉切割断裂2例,突破股骨头断裂1例。所有患者均采用经骨隧道关节镜技术取出股骨颈断裂克氏针,其中6例新鲜骨折取出断针后继续按计划进行内固定;1例空心环钻开通骨隧道,取出断针后进行异体骨植骨。记录手术时间、出血量、额外取骨量、植骨量、骨隧道远端与关节面距离。结果:所有患者均手术顺利,手术时间17~40 min,平均(23.30±3.90)min;出血量20-30 ml,平均(16.20±4.40)ml。额外取骨量0~7 cm3,平均(0.35±0.06)cm3;异体骨植骨量2~6g,平均(3.10±0.50)g。骨隧道远端与关节面距离0.5~5.0cm,平均(1.80±1.00)cm。结论:经骨隧道关节镜技术应用于股骨颈断裂克氏针取出,具有损伤小、高效的优点,术中无需额外破坏隧道周围骨质,断针取出后可以继续执行内固定计划。

    Abstract:

    Objective: To evaluate the effect of retrieval of broken wire in femoral neck with bone endoscopy. Method: Between March 2011 and Mar 2020,7 patients with broken wire in femoral neck were treated.2 cases were male and 5 cases were female.The average age was 48.3±6.0 years[range 32 to 67 years].There were 1 case at left side and 6 cases at right side.About location of broken wire,there were 1 case in femoral neck ,5 cases in femoral head and 1 case protruding into the hip joint.There were 6 frash and 1 old broken wire.According to broken reason,1 case was due to material,3 cases was due to drill cutting,2 cases was due to screw cutting,and 1 case was due to penetrating into hip joint. All patients were treated by bone endoscopy,and 6 cases continue to internal fixation and 1 case continue to bone grafting with allograft. Operation time,blood loss,additional bone loss,mass of bone graft,distance between distal tunnel and articular surface. Result:All patients underwent successful operation. The average operation time was 23.30±3.90 min(range 17 to 40 min),and the average blood loss was 16.20±4.40 ml(range 20 to 30 ml).The average additional bone loss was 0.35±0.06 cm3(range 0 to 7 cm3),and the average mass of bone graft was 3.10±0.50 g(range 2 to 6 g).The average distance between distal tunnel and articular surface was 1.80±1.00 cm(range 0.5 to 5.0 cm). Conclusion:Retrieval of broken wire in femoral neck with bone endoscopy is efficient and little injury.It do not need to additionally damage surrounding the tunnel,and can continue to internal fixation after broken wire removing.

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  • 收稿日期:2021-05-05
  • 最后修改日期:2021-08-11
  • 录用日期:2021-09-08
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