| 有限切开髓内固定治疗难复性股骨转子下骨折 |
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投稿时间：2018-10-18
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| 作者 | Author | 单位 | Address | E-Mail |
| 李亮亮 |
LI Liang-liang |
山西医科大学第二医院骨科, 山西 太原 030001 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 张志强 |
ZHANG Zhi-qiang |
山西医科大学第二医院骨科, 山西 太原 030001 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China |
z13393430930@163.com |
| 王涛 |
WANG Tao |
山西医科大学第二医院骨科, 山西 太原 030001 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 焦强 |
JIAO Qiang |
山西医科大学第二医院骨科, 山西 太原 030001 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 石俊俊 |
SHI Jun-jun |
山西医科大学第二医院骨科, 山西 太原 030001 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 李渊 |
LI Yuan |
山西医科大学第二医院骨科, 山西 太原 030001 |
Department of Orthopaedics, the Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi, China |
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| 期刊信息：《中国骨伤》2019年，第32卷，第2期，第116-119页 |
| DOI：10.3969/j.issn.1003-0034.2019.02.005 |
| 基金项目: |
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中文摘要:
目的：探讨骨科牵引床辅助下有限切开髓内固定治疗难复性股骨转子间骨折的手术技巧及临床疗效。
方法：2015年7月至2017年10月治疗12例股骨转子下骨折患者，男9例，女3例；年龄33~67岁，平均44岁；左侧10例，右侧2例；高处坠落伤8例，交通事故伤4例；伤后2~5 d接受手术治疗。骨折按Seinsheimer分型：ⅢA型8例，ⅢB型2例，Ⅳ型2例；均为闭合性损伤。术前骨科牵引床闭合复位，手术采用有限切开加长InterTan髓内钉内固定术。术后采用Sanders髋关节等级评分进行疗效评价。
结果：12例患者均获得随访，时间6~24个月，平均12个月。所有骨折获得骨性愈合，愈合时间3~6个月，平均4个月。术后Sanders创伤性髋关节疗效评价结果，优9例，良2例，中1例。所有病例未出现骨折部位感染、内固定松动断裂、畸形愈合等并发症。
结论：牵引床辅助下结合有限切开复位，可很好解决复杂转子下骨折的术中复位问题，节约手术时间，减少出血，结合髓内固定，可获得骨折断端良好的对位对线和稳定性，为治疗难复性股骨转子下骨折提供了一种方法。 |
| 【关键词】股骨骨折 髋 牵引术 骨折固定术,髓内 |
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| Limited open reduction and intramedullary fixation for the treatment of refractory femoral subtrochanteric fractures |
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ABSTRACT
Objective: To explore the surgical technique and clinical effect of limited open reduction and intramedullary fixation assisted with orthopedic traction bed for the treatment of femoral subtrochanteric fractures.
Methods: From July 2015 to October 2017, 12 patients with femoral subtrochanteric fractures were treated including 9 males and 3 females with an average age of 44 years old ranging from 33 to 67 years old. Among them, 10 cases were on the left trochanter and 2 on the right, and there were 8 cases of highly fall injury and 4 cases of traffic accident injury. All patients received operation at 2 to 5 days after injury. According to the Seinsheimer classification, 8 cases were type ⅢA, 2 were type ⅢB and 2 were type Ⅳ, and all cases were closed injury. The patients were placed on the orthopedic traction bed for trial closed reduction to maintain proper traction before operation. Under C-arm X-ray fluoroscopy, it was advisable to take the fracture end of the main bone block without obvious shortening and shifting. Then limited incision and lengthened InterTan intramedullary nailing were performed, and the Sanders traumatic hip score was used to evaluate the postoperative efficacy.
Results: All 12 patients were followed up from 6 to 24 months with an average of 12 months. All cases were received bone healing at 3 to 6 months with an average time of 4 months. According to the Sanders grades, the results were excellent in 9 cases, good in 2 cases and medium in 1 case. Infection, breakage of internal fixation loosening and adverse complications such as malunion were not appeared in all the cases.
Conclusion: Limited open reduction assisted with traction bed can be effective to solve the problem of the intraoperative reduction in the complex subtrochanteric fractures, which could save operation time and decrease bleeding. Combined with intramedullary fixation, this method could acquire good counterpoint and stability for the fracture end, and provide a method for the treatment of refractory subtrochanteric fractures. |
| KEY WORDS Femoral fractures Hip Traction Fracture fixation,intramedullary |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李亮亮,张志强,王涛,焦强,石俊俊,李渊.有限切开髓内固定治疗难复性股骨转子下骨折[J].中国骨伤,2019,32(2):116~119 |
| 英文格式: | LI Liang-liang,ZHANG Zhi-qiang,WANG Tao,JIAO Qiang,SHI Jun-jun,LI Yuan.Limited open reduction and intramedullary fixation for the treatment of refractory femoral subtrochanteric fractures[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(2):116~119 |
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