摘要
目的对动力髋螺钉(dynamic hip screw,DHS)内固定术失败的原因进行归纳分析,以期提高手术成功率。方法回顾分析我院2001年1月～2010年12月应用DHS内固定术治疗的股骨转子周围骨折214例的临床资料,分析手术失败原因。结果本组DHS内固定术失败原因分别为DHS穿出股骨头、DHS切割股骨头颈、髋内翻角度增加≥10°、DHS滑动超过20 mm、DHS或钢板松动断裂、内固定物松动造成骨不连。股骨颈基底骨折DHS内固定术失败率为8.7%;股骨转子间骨折DHS内固定术失败率为4.6%,其中A3型失败率显著高于A1型和A2型;股骨转子下骨折DHS内固定术失败率为12.5%。不同尖顶距(tip-apex distance,TAD)骨折DHS内固定术失败率不同,其中TAD≤25 mm者为1.0%,TAD 26～50 mm者为3.8%,TAD>50 mm者为27.6%。结论了解DHS生物力学特点、严格掌握手术适应证、熟练精确手术操作是保证DHS内固定术成功的重要因素。
Objective In order to improve the success rate of operation,we analyzed the cause of failure of dynamic hip screw（DHS）.Methods We retrospectively analyzed 214 femoral peritrochanteric fractures who had been treated by DHS fixation between January 2001 and December 2010.Results The failure causes included DHS though femoral head,DHS cut-out,coax vara angle increase of ≥10°,DHS sliding more than 20 mm,screw or plate loosening or breakage and the bone nonunion.The incidence rate of femoral neck basilar fracture was 8.7%;the incidence rate of intertrochanteric fracture was 4.6 %.The failure rate of type A3 was significantly higher than the failure rate of type A1 and A2;the incidence rate of subtrochanteric fractures was 12.5%.Different TAD（tip-apex distance） caused different failure rates of internal fixation.The incidence rate of TAD≤25 mm was 1.0%,the incidence rate of TAD 26-50 mm was 3.8%,the incidence rate of TAD50 mm was 27.6%.Conclusion Knowledge of biomechanical characteristics of DHS,strict selection of patients and precise and skilled operations are the important factors to guarantee the success of DHS internal fixation.
出处
《临床误诊误治》
2011年第11期35-37,共3页
Clinical Misdiagnosis & Mistherapy
关键词
骨折
股骨
动力髋螺钉
骨折固定术
内
Fracture
Dynamic hip screw
Femur
Fracture fixation
internal
