| 合并冠状面骨折的股骨转子间严重粉碎性骨折外科治疗的临床对照研究 |
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投稿时间：2009-12-25
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| 作者 | Author | 单位 | Address | E-Mail |
| 甄平 |
ZHEN Ping |
兰州军区兰州总医院全军骨科中心,甘肃 兰州 730050 |
Department of Orthopaedics,the General Hospital of PLA,Lanzhou 730050,Gansu,China ABSTRACT |
Zhouliwu2000@sina.com |
| 刘兴炎 |
LIU Xing-yan |
兰州军区兰州总医院全军骨科中心,甘肃 兰州 730050 |
Department of Orthopaedics,the General Hospital of PLA,Lanzhou 730050,Gansu,China ABSTRACT |
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| 高明暄 |
GAO Ming-xuan |
兰州军区兰州总医院全军骨科中心,甘肃 兰州 730050 |
Department of Orthopaedics,the General Hospital of PLA,Lanzhou 730050,Gansu,China ABSTRACT |
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| 田琦 |
TIAN Qi |
兰州军区兰州总医院全军骨科中心,甘肃 兰州 730050 |
Department of Orthopaedics,the General Hospital of PLA,Lanzhou 730050,Gansu,China ABSTRACT |
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| 期刊信息：《中国骨伤》2010年，第23卷，第5期，第332-335页 |
| DOI：10.3969/j.issn.1003-0034.2010.05.003 |
| 基金项目: |
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中文摘要:
目的：探讨半环式梯形加压钢板及股骨近端解剖型钢板固定治疗合并冠状面骨折的股骨转子间严重粉碎性骨折的疗效及手术特点。
方法：1998年1月至2007年3月，57例合并冠状面骨折的股骨转子间严重粉碎性骨折的患者分成两组：采用自行研制的半环式梯形加压钢板固定21例，男11例，女10例，平均年龄41.8岁；采用股骨近端解剖型钢板固定36例，男17例，女19例，平均年龄42.1岁。两组的骨折按照AO分类均为股骨转子间A3型骨折。术后髋关节依据Harris评分标准进行评定。
结果：57例获得随访，时间5个月～9年3个月，平均4.8年；骨折愈合时间8～20周，平均12.8周。Harris评分结果显示：解剖钢板组疼痛评分明显高于梯形加压钢板组(P<0.05);髋关节功能评分解剖钢板组明显高于梯形加压钢板组(P<0.01);畸形及关节活动范围两组比较差异无统计学意义(P>0.05).
结论：合并冠状面骨折的股骨转子间严重粉碎性骨折因转子外侧部骨皮质完整性受到破坏，以此为力学支点进行穿钉固定的多种内固定物应用受限制，股骨近端解剖钢板和半环式梯形加压钢板可有效解决这一问题。 |
| 【关键词】股骨 髋骨折 骨折固定术,内 外科手术 临床对照试验 |
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| Application of the anatomic plate and trapezoid plate in comminuted intertrochanteric fracture combined with trochanteric coronal position fracture:a controlled clinical trial |
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ABSTRACT
Objective: To investigate the therapeutic effect and operative characteristic of the anatomic plate and trapezoid plate for treament of the comminuted intertrochanteric fracture combined with trochanteric coronal position fracture.
Methods: From Jan. 1998 to Mar. 2007,57 patients suffered from comminuted intertrochanteric fracture combined with trochanteric coronal position fracture were randomly divided into two groups,21 patients in trapezoid plate group were treated with the trapezoid compression plate,included 11 males and 10 females with an average age of 41.8 years; and 36 patients in anatomic plate group were treated with the anatomic plate,included 17 males and 19 females with an average age of 42.1years. All of the 57 fractures were A3 type according to AO classification. The functions of hip joints were evaluated according to the Harris hip functional standard score.
Results: All 57 patients were followed-up for 5 months to 9 years and 3 months with an average of 4.8 years. The healing time of the fractures was from 8 to 20 weeks with an average of 12.8 weeks. The results of Harris scoring showed the pain scores of the anatomic plate group were higher than that of the trapezoid plate group(P<0.05). The function scores of the anatomic plate group were higher than that of the trapezoid plate group(P<0.01). There were no statistically significant different in the deformity and ranges of joint scores between two groups(P>0.05).
Conclusion: In unstable comminuted intertrochanteric fracture combined with trochanteric coronal position fracture,the lateral wall of trochanteric is often destroyed. The anatomic plate and the trapeziod compression plate can provide effective internal fixation,while many othere internal fixation methods were limited in this kind of fracture. As compared with the anatomic plate fixation,the trapezoid compression plate fixation of comminuted intertrochanteric fracture combined with trochanteric coronal position fracture have several advantages, such as fewer complications,faster union of fracture and earlier recovery of joint functions. |
| KEY WORDS Femur Hip fractures Fracture fixation,internal Surgical procedures,operative Controlled clinical trials |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 甄平,刘兴炎,高明暄,田琦.合并冠状面骨折的股骨转子间严重粉碎性骨折外科治疗的临床对照研究[J].中国骨伤,2010,23(5):332~335 |
| 英文格式: | ZHEN Ping,LIU Xing-yan,GAO Ming-xuan,TIAN Qi.Application of the anatomic plate and trapezoid plate in comminuted intertrochanteric fracture combined with trochanteric coronal position fracture:a controlled clinical trial[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(5):332~335 |
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