Reunderstanding of Garden Type I Femoral Neck Fractures by 3-dimensional Reconstruction
Reunderstanding of Garden Type I Femoral Neck Fractures by 3-dimensional Reconstruction
复制标题
三维重建重新认识 Garden I 型股骨颈骨折
DOI：
10.3928/01477447-20130523-31
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发表时间：
2013-06-01
期刊：
影响因子：
1.1
通讯作者：
Li, Zhi-jun
中科院分区：
文献类型：
--
作者：
Du, Chang-ling;Ma, Xin-long;Li, Zhi-jun
Garden I型骨折包括不完全骨折和嵌顿骨折。随着科学技术和医疗的进步，花园分类的某些缺陷变得明显。作者假设不完全股骨颈骨折的发生率较低，嵌顿股骨颈骨折不是无移位和稳定骨折。提出了一种精确测量股骨颈骨折患者股骨头空间位移的新方法。2008年至2011年，966例股骨颈骨折患者接受了治疗，其中48例为Garden I型骨折，如前后位X线片所示。X光片上有7处骨折被归类为不完全骨折;然而，经过三维重建后，3处骨折被归类为不完全骨折，4处骨折被归类为完全骨折。此外，其余41例Garden I型骨折在X线片上被归类为嵌顿骨折，在三维重建上显示出较大的空间位移。股骨头平均旋转位移为19.29 ° ± 10.51 °，股骨头中心和头凹最低点的平均位移分别为8.76 ± 4.45和14.39 ± 8.08 mm。这项研究表明，不完全性股骨颈骨折的发生率很低。股骨颈骨折表现出不同程度的移位，而不是无移位的稳定骨折。Garden分类法对股骨颈骨折的诊断有一定的局限性。撞击性股骨颈骨折应与Garden I型骨折相鉴别，以便临床医生为这些骨折选择合适的治疗方法。
Garden type I fractures include incomplete fractures and impacted fractures. With advances in scientific technology and medical treatment, certain deficiencies of the Garden classification have become apparent. The authors hypothesized that the incidence of incomplete femoral neck fractures was low and that impacted femoral neck fractures were not undisplaced and stable fractures. A new method was developed to precisely measure the spatial displacement of the femoral head in impacted femoral neck fractures. Between 2008 and 2011, nine hundred sixty-six patients with femoral neck fractures were treated, 48 of whom had Garden type I fractures, as seen on anteroposterior radiographs. Seven fractures were classified as incomplete on radiographs; however, after 3-dimensional reconstruction, 3 were classified as incomplete and 4 as complete fractures. Furthermore, the remaining 41 Garden I fractures that were classified as impacted on radiographs showed large spatial displacement on 3-dimensional reconstruction. The average rotational displacement of the femoral head was 19.29 degrees +/- 10.51 degrees, and the average displacements of the femoral head center and the lowest point of the fovea capitis were 8.76 +/- 4.45 and 14.39 +/- 8.08 mm, respectively. This study showed that the incidence of incomplete femoral neck fractures was low. Impacted femoral neck fractures showed variable degrees of displacement and were not undisplaced, stable fractures. Garden classification for impacted femoral neck fractures has certain limitations. Impacted femoral neck fractures should be differentiated from Garden type I fractures so clinicians can select appropriate treatments for these fractures.