评估老年无移位型股骨颈骨折空心加压螺钉内固定的长期疗效。

回顾性收集南京大学医学院附属鼓楼医院有完整随访资料的老年无移位型股骨颈骨折患者42例，患者接受空心加压螺钉内固定手术的平均年龄为（72±5）岁（65~85岁）。记录患者生存状况、术后复查情况、X线情况及再次手术情况；采用Harris评分评价末次随访时的髋关节功能，并采用疼痛视觉模拟评分（VAS）评价髋部疼痛情况。

36例患者获得满意随访，随访率85.7%，平均随访时间为（6.6±2.9）年（2.1~10.6年）。健在患者36例（36/42，85.7%），已故患者6例（7/42，14.3%）。5例（5/42，11.9%）出现股骨头坏死，无骨折不愈合。1例患者（1/42，2.4%）因股骨头坏死而再次手术，实施率为2.4%（1/42）。除去已故及行关节置换患者外，其余35例患者末次随访时髋关节Harris评分为（83±9）分；VAS评分为（0.6±1.0）分（0~4分）。

对于老年无移位型股骨颈骨折，空心加压螺钉固定是一种值得推荐的治疗方法。

To evaluate the long-term outcome of cancellous lag screw fixation for nondisplaced femoral neck fracture in elderly patients.

Forty-two elderly patients with nondisplaced femoral neck fracture with complete data were included in the present study. The average age was (72±5) years (65-85 years) when they received surgery, The following items were recorded: the patients' living condition, reexamine in the out clinic after discharge, X rays and reoperation. The clinical outcomes were evaluated by Harris hip score, the pain and walk ability were evaluated by VAS score and self made scale.

All patients were well followed up, the rate was 85.7%. The average follow-up was (6.6±2.9) years (2.1-10.6 years). Thirty-six patients (36/42, 85.7%) are still living, 6 patients (7/42, 14.3%) died. No nonunion was found, avascular necrosis were found in 11.9% (5/42) patients, while only 1 patient (2.4%, 1/42) received reoperation. For the living patients, the Harris score of the left 35 patients were 83±9, the VAS pain score was 0.6±1.0 (0-4 score).

Cancellous lag screw fixation was a valuable method for the treatment of nondisplaced femoral neck fracture in elderly patients.