摘要
目的探讨在动力髋螺钉(dynamic hip screw,DHS)治疗股骨粗隆间骨折同时加用防旋螺钉的意义。方法 2006年4月-2010年1月,收治22例股骨粗隆间骨折患者。男15例,女7例;年龄54～83岁,平均66.3岁。跌伤16例,交通事故伤5例,高处坠落伤1例。均为闭合骨折。左侧13例,右侧9例。单纯股骨粗隆间骨折18例,合并Colles骨折4例。骨折按改良的Evans分型:Ⅰ型14例,Ⅱ型6例,Ⅲ型1例,Ⅳ型1例。伤后至手术时间3～7 d,平均4.5 d。术中采用DHS加用1枚防旋螺钉固定骨折。结果手术时间51～95 min,平均72 min;术中出血量150～350 mL,平均270 mL;住院时间12～35 d,平均16.8 d。术后患者切口均Ⅰ期愈合。22例均获随访,随访时间6～17个月,平均14个月。X线片示骨折均于术后12～16周达临床愈合,平均13.6周。无内固定物松动脱出、DHS滑动钉穿破股骨头、髋内翻等并发症发生。髋关节功能按照黄公怡疗效评价标准评定,获优19例,良3例。结论 DHS治疗股骨粗隆间骨折时加用1枚防旋螺钉,未明显增加手术时间,提高了骨折固定的牢固程度及抗旋转能力。
Objective To investigate the appl ication of anti-rotation screw after dynamic hi p screw （DHS） in treatment of intertrochanteric fracture. Methods Between April 2006 and January 2010, 22 cases of intertrochanteric fractures underwent DHS fixation operation with an anti-rotation screw, including 15 males and 7 females with an average age
of 66.3 years （range, 54-83 years）. Fractures were caused by sl ipping in 16 cases, traffic accident in 5 cases, and fall ing from height in 1 case. All cases showed closed fractures, including 13 cases in the left and 9 cases in the right. Eighteen cases were simple intertrochanteric fracture, 4 cases were intertrochanteric fractures compl icated with Colles fractures. According to Evans classification standard, there were 14 cases of type I, 6 cases of type II, 1 case of type III, and 1 case of type IV. The time from wound to operation was 3-7 days （mean, 4.5 days）. Results The operation time ranged from 51-95 minutes （mean, 72 minutes）. The intraoperative blood loss was 150-350 mL （mean, 270 mL）. The hospital ization days were 12-35 days （mean, 16.8 days）. Primary heal ing was observed in all cases. All cases were followed up 6-17 months （mean, 14 months）. Union of fracture was observed at 12-16 weeks （mean, 13.6 weeks）; no fracture or internal fixation loosening occurred. According to HUANG Gongyi’s standard of efficacy assessment, the results were excellent in 19 cases and good in 3 cases. Conclusion Appl ication of an anti-rotation screw can help to improve the strength of the DHS for the internal fixation of intertrochanteric fracture, especially the anti-rotation abil ity, which does not increase the operation time obviously.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2011年第3期334-336,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
股骨粗隆间骨折
动力髋螺钉
防旋螺钉
内固定
Intertrochanteric fracture Dynamic hi p screw Anti-rotation screw Internal fixation
