Treatment for intracapsular fracture of the femoral neck using a compression hip screw.

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概要

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• Internal fixations using a compression hip screw were performed in 18 cases with intracapsular fractures of the femoral neck. These cases were divided according to Garden's classification into the following sub-groups; Stage II (3 cases), Stage III (8 cases) and Stage IV (7 cases) .<BR>The method of reduction for the Stage III group is different from that for the Stage IV. In the former, vigorous internal rotation and abduction are necessary, while in the latter, overtraction should be avoided. Because of the wide range for rotationary displacement permissible, about 60°rotation is acceptable. However, the deformity ascribed to adduction is a contraindication for the procedure.<BR>The method of operation differs from the fixation of a compression hip screw for extracapsular fractures. Prior to reaming, two guide pins must be inserted in the acetabulum in parallel with each other. The lag screw should be inserted deep into the site beneath the subchondral bone, aiming at the lower one-third of the femoral head.<BR>Weight bearing can be started at the end of the 2nd week postoperatively and despite the presence or absence of bony union, progression to walking on crutches can be achieved on stabilization of the patient's gait. But great care should be taken to assure that the patient doesn't falling down. When this occurred, the X-ray finding of note was the appearance of a space due to a cutting interaction between the lag screw and the cancellous bone of the femoral head. Examination of AP and axial view X-rays are of this space mandatory for the determination of the presence.

• 日本関節病学会の論文

日本関節病学会 | 論文

• 関節リウマチ患者における手術と機能回復
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• 変形性関節症に対するグルコサミン・コンドロイチンの有用性 (第36回[日本関節病]学会寄稿)
• 人工膝関節再置換術の経験--脛骨結節骨切り術の適応と合併症について
• RA頚椎病変に対する上位頚椎後方除圧固定術の治療成績と問題点

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