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动力髋螺钉治疗股骨粗隆间骨折226例临床观察

Clinical observation of 226 cases of treating intertrochanteric fracture of femur by dynamic hip screw
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摘要 [背景]评价动力髋螺钉(DHS)在股骨粗隆间不稳定骨折中的应用,探讨影响其疗效的因素.[病例报告]根据Evan’s分类法给226例粗隆间骨折患者进行分类,并给予透视下复位DHS内固定治疗.术后常规行股骨颈正侧位拍片,评价骨折复位质量,获取尖顶距,并跟踪随访,观察疗效.随访时间为8~28个月,平均为16个月.12例发生不同程度的并发症,其中髋内翻为7例,髋螺钉切出为3例,顶出为2例;疗效评定为优为182例,良为32例,优良率为94.7%.[讨论]在手术治疗股骨粗隆间骨折过程中DHS可提供有效的内固定,术中应在C型臂指导下提高复位质量,正确掌握内固定物位置,即可有效减少各种并发症的发生,达到理想效果. BACKGROUND To evaluate the application of dynamic hip screw(DHS) for treating the intertrochanteric unstable fracture of femur and to investigate the factors of affecting the curative effects.CASE REPORTS226 cases of intertrochanteric fracture of femur were classified according to the Evan's classification and fracture reduction was treated by DHS under C arm X-ray machine.The photos of femoral neck routinely after operations were shoted,evaluated the equlity of fracture reductions and got the tip-apex distance.All the patients were followed up for 8—28 months(average of 16 months).12 cases happened different complications,including 7 cases of coxa vara,5 cases of out loosening of DHS and 2 cases of out of the femur head top.The evaluation of curative effect was showed that 182 cases was excellent,32 cases was good,and fine rate is 94.7%.DISCUSSIONIn operative process of intertrochanteric fracture of femur,the DHS could provide effective internal fixation,the quality of reduction should be improve under C arm X-ray machine and the position of internal fixation material master correctly to effectively reduce the occurrence of various kinds of complications to acquire ideal therapeutic effects.
作者 金日 李林
出处 《延边大学医学学报》 CAS 2010年第4期286-288,共3页 Journal of Medical Science Yanbian University
关键词 股骨骨折 动力髋螺钉 骨折固定术 femoral fractures dynamic hip screw fracture fixation
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