大腿骨頚部内側骨折に対するHansson pinを用いた観血的骨接合術の治療成績―Cannulated cancellous hip screwとの比較検討

Clinical Results of Osteosynthesis of Femoral Neck Fractures with a Hansson Pin : Comparison with Osteosynthesis with a Cannulated Cancellous Hip Screw

　抄録：31例32股の大腿骨頚部内側骨折に対して，Hansson pinを用いて骨接合術を行った15例16股（H群）とcannulated cancellous hip screwを用いて骨接合術を行った16例16股（C群）の骨癒合の有無および術後合併症を調査し，術後のX線学的評価〔Garden Alignment Index（GAI），頚部短縮量〕を両群間で比較検討した．結果，合併症として術後の大腿骨転子下骨折をH群の1股に，大腿骨頭壊死の発生をH群の1股，C群の2股に認めたが，その他の症例は全例で骨癒合が得られた．骨癒合を得た症例のGAIと頚部短縮量に関しては両群間に有意差を認めなかった．本研究により大腿骨頚部内側骨折に対するHansson pinはこれまで安定した治療成績が報告されているcannulated cancellous hip screwと同等の治療成績が得られ，さらにその大腿骨頭に対する低侵襲の点から，今後も本骨折に対して使用可能な内固定材料であると考えられた．

　We evaluated the clinical results of osteosynthesis of 32 femoral neck fractures in 31 patients with a Hansson pin (H group) or a cannulated cancellous hip screw (C group). The H group consisted of 15 patients (5 men, 10 women) with 16 fractures, and the C group consisted 16 patients (3 men, 13 women) with 16 fractures. The clinical evaluation was based on operation time, blood loss, walking ability, fracture union rate, and complications. In addition, the Garden alignment index and degree of neck shortening were measured radiographically. Complications consisted of subtrochanteric fracture in one case and to osteonecrosis of the femoral head in two cases in the H group, and osteronecrosis of the femoral head in one case in the C group. There were no significant differences between the two groups in the results of the clinical and radiographic evaluations. The results of this study demonstrate that the Hansson pin can be used as an instrument to treat femoral neck fracture, because the results of osteosynthesis with Hansson pins were as good as that of osteosynthesis cannulated cancellous hip screws.