後期高齢者大腿骨頸部骨折に対するCross Screw法の治療成績  [in Japanese] Clinical Results of Cross Screw Fixation for Femoral Neck Fracture in Patients over 75  [in Japanese]

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Abstract

当院では大腿骨頸部骨折の治療にCannulated Cancellous Screw 2本を用いて(以下Cross Screw法)固定を行ってきた.2006年1月~2009年3月までの非転位型大腿骨頸部骨折にCross Screw法をおこなった高齢者46例のうち,受傷時年齢が75歳以上,術後6ヶ月以上経過が確認できた23例の治療成績を報告する.対象は男性3例,女性20例,平均年齢81.6歳であった.骨折型は全例非転位型であり,受診から手術までの期間は平均1.5日であった.手術は局所麻酔16例,腰椎麻酔7例下に行った.骨癒合の有無,術後合併症,歩行能力の変化などを検討した.全例に骨癒合が得られたが,経過中に3例late segmental collapseを合併し,2例に人工骨頭置換術を施行した.創感染や創治癒遅延,転子下骨折などの術後合併症は生じておらず,歩行能力の極端な低下は認めなかった.高齢者の大腿骨頸部骨折にCross screw法は有効な手術法のひとつと考えた.

We used two cannulated cancellous screws called cross screw fixation for 46 cases who underwent operation for undisplaced femoral neck fracture at our hospital between January 2006 and March 2009. Of these, we report the clinical results of 23 cases (3 males, 20 females) over 75 years old who were observed for over six months. The average age of these 23 patients at the time of injury was 81.6 years old. The average length of time from injury to fixation was 1.5 days. Sixteen patients were given local anesthesia and seven patients were given spinal anesthesia. We examined bone union rate, complications following surgery, and alternation of gait ability. All patients achieved bone union and none of them developed complications such as skin irritation, infection, and subtrochanteric fracture. Cross screw fixation is an effective surgical method for undisplaced femoral neck fracture in older adults.

Journal

  • Orthopedics & Traumatology

    Orthopedics & Traumatology 59(3), 413-418, 2010

    West-Japanese Society of Orthopedics & Traumatology

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