| 伴有后方冠状面骨折的A2.3型股骨转子间骨折的临床特点和治疗 |
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投稿时间：2015-11-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 王俭 |
WANG Jian |
浙江大学医学院附属第二医院骨科, 浙江 杭州 310009 |
Department of Orthopaedics, the Second Affiliated Hospital of Medicine College of Zhejiang University, Hangzhou 310009, Zhejiang, China |
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| 叶招明 |
YE Zhao-ming |
浙江大学医学院附属第二医院骨科, 浙江 杭州 310009 |
Department of Orthopaedics, the Second Affiliated Hospital of Medicine College of Zhejiang University, Hangzhou 310009, Zhejiang, China |
yezhaominghz@163.com |
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| 期刊信息：《中国骨伤》2016年，第29卷，第8期，第697-701页 |
| DOI：10.3969/j.issn.1003-0034.2016.08.005 |
| 基金项目: |
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| 中文摘要:目的：探讨伴有后方冠状面骨折的A2.3型股骨转子间骨折的特点、手术技巧和疗效。方法：2011年1月至2014年1月，采用股骨近端防旋髓内钉治疗33例伴有后方冠状面骨折的股骨转子间骨折的患者，其中男15例，女18例；年龄61～92岁，平均（73.1±8.2）岁；按照AO/OTA分型，均为A2.3型；均为闭合性骨折。均采取有限切开辅助复位内固定术，采用Harris髋关节评分标准对术后疗效进行评价。结果：1例术后19 d死亡，32例获得随访，随访时间9～24个月，平均（16.3±5.1）个月；根据X线片随访，骨折愈合时间6～9个月，平均（7.2±1.5）个月。末次随访Harris髋关节功能评分为76～95分，平均（85.3±5.6）分；其中优13例，良16例，可3例。结论：伴有后方冠状面骨折的A2.3型股骨转子间骨折类型特殊，复位困难，又相当不稳定，需使用辅助切口复位，并采用近端抗旋髓内钉固定，术后康复锻炼亦需个体化。 |
| 【关键词】股骨骨折 骨折固定术,内 外科手术 |
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| Clinical characteristics and treatment of AO/OTA A2.3 intertrochanteric fractures with posterior coronal plane fractures |
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| ABSTRACT Objective: To explore the characteristics,the operative techniques and effect of AO/OTA A2.3 intertrochanteric fractures with posterior coronal fractures. Methods: From January 2011 to January 2014,33 patients suffered from AO/OTA A2.3 intertrochanteric fractures with posterior coronal fractures were treated with proximal femoral anti-rotation nail,included 15 males and 18 females,with an average age of (73.1±8.2) years old ranged from 61 to 92 years old. According to AO/OTA classification,all cases were type A2.3 fracture. All cases were closed fractures and treated with limited open reduction and internal fixation. The postoperative hip function was evaluated by Harris score. Results: One case was died at 19 days after operation,32 cases were followed up from 9 to 24 months with an average of (16.3±5.1) months. Bone union time was from 6 to 9 months with an average of(7.2±1.5) months according to X-rays. At the final followed-up,Harris scores were 76 to 95 points with an average of (85.3±5.6) points;13 cases were classified as excellent,16 as good,and 3 as fair. Conclusion: AO/OTA A2.3 intertrochanteric fracture with posterior coronal fractures is a special type and unstable,it's difficult to reset. It needs to be fixed with proximal femoral anti-rotation nail by limited open reduction. It is necessary that postoperative rehabilitation should be chosen individually. |
| KEY WORDS Femoral fractures Fracture fixation,internal Surgical procedures,operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王俭,叶招明.伴有后方冠状面骨折的A2.3型股骨转子间骨折的临床特点和治疗[J].中国骨伤,2016,29(8):697~701 |
| 英文格式: | WANG Jian,YE Zhao-ming.Clinical characteristics and treatment of AO/OTA A2.3 intertrochanteric fractures with posterior coronal plane fractures[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(8):697~701 |
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