| 转子间骨折固定失效13例临床分析 |
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Received:April 26, 2009
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| 作者 | Author | 单位 | Unit | E-Mail |
| 曲巧格 |
QU Qiao-ge |
邢台矿业集团总医院骨四科,河北 邢台 054000 |
Department of Trauma Orthopaedics,Xingtai Mining Industry Group Total Hospital,Xingtai 054000,Hebei,China |
quqiaoge@163.com |
| 王杰华 |
WANG Jie-hua |
邢台矿业集团总医院骨四科,河北 邢台 054000 |
Department of Trauma Orthopaedics,Xingtai Mining Industry Group Total Hospital,Xingtai 054000,Hebei,China |
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| 游小军 |
YOU Xiao-jun |
邢台矿业集团总医院骨四科,河北 邢台 054000 |
Department of Trauma Orthopaedics,Xingtai Mining Industry Group Total Hospital,Xingtai 054000,Hebei,China |
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| 期刊信息：《中国骨伤》2009年22卷，第9期，第702-703页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的：分析转子间骨折固定失效的原因，以正确选择手术适应证和固定方法。
方法：回顾性分析1997年9月至2008年9月13例转子间骨折手术后固定失效的临床资料，总结失效原因。男7例，女6例；年龄58～93岁，平均71岁。髓内固定2例，近端解剖型钢板固定4例，DHS固定3例，空心加压螺钉2例，外固定架2例。按Evans分型：Ⅱ型1例，Ⅲ型7例，Ⅳ型5例。
结果：不稳定性骨折复位不良未植骨8例，股骨颈内钉植入位置不良6例。术后颈干角复位90°以下3例，90°～110° 7例，110°～130° 3例。内固定钉退出5例，颈内固定钉向外上切出6例，过早负重3例，骨质疏松10例，发生时间术后6周～11个月，平均4.5个月。
结论：转子间骨折发生固定失效主要与骨折类型、复位状况、固定方法掌握的准确性、骨质疏松、负重时间有关。 |
| [关键词]:髋骨折 骨折固定术 治疗失败 负重 |
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| Clinical analysis for fixation failure of 13 patients with intertrochanteric fractures |
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Abstract:
Objective: To analysis the reasons of fixation failure for intertrochanteric fractures,so as to select correct operation indications and fixation methods.
Methods: Retrospective analysis the clinical data of 13 patients with failed internal fixation of intertrochanteric fractures from September 1997 to September 2008,and the failure reasons were summarized. There were 7 males and 6 females,ranging in age from 58 to 93 years,averaged 71 years. Two patients were treated with intramedullary fixation,4 patients with anatomical proximal femoral plate,3 patients with DHS fixation,2 patients with hollow compression screws,and 2 patients with external fixation. According to Evans types:1 patient was type Ⅱ，7 patients were type Ⅲ，and 5 patients were type Ⅳ。
Results: Eight patients with unstable fractures and malreduction had no grafted bone. Six patients had bad position of neck screws in the femur neck. Postoperative collodiaphyseal angle:3 patients were under 90 degree,7 patients 90 to 110 degree,and 3 patients 110 to 130 degree. Five patients had internal fixed screw exited,6 patients had neck screws cutting to superior lateral,3 patients had early weight bearing,and 10 patients were osteoporosis occurred after operation from 6 weeks to 11 months,averaged 4.5 months.
Conclusion: The fixation failure of intertrochanteric fractures was concerned with fractures types,reduction,fixation methods,osteoporosis and the time of weight bearing. |
| KEYWORDS:Hip fractures Fracture fixation Treatment failure Weight-bearing |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 曲巧格,王杰华,游小军.转子间骨折固定失效13例临床分析[J].中国骨伤,2009,22(9):702~703 |
| 英文格式: | QU Qiao-ge,WANG Jie-hua,YOU Xiao-jun.Clinical analysis for fixation failure of 13 patients with intertrochanteric fractures[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(9):702~703 |
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