| 动力髋螺钉内固定治疗股骨转子间骨折失败原因分析 |
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Received:November 25, 2009
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| 作者 | Author | 单位 | Unit | E-Mail |
| 周中 |
ZHOU Zhong |
江苏省中西医结合医院骨科,江苏 南京 210028 |
Department of Orthopaedics of Jiangsu Hospital of Integrated Traditional Chinese Medicine and Western Medicine,Nanjing 210028,Jiangsu,ChinaABSTRACT |
zhouzhong.007@163.com |
| 熊进 |
XIONG Jin |
南京大学医学院附属鼓楼医院骨科 |
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| 江宁 |
JIANG Ning |
江苏省中西医结合医院骨科,江苏 南京 210028 |
Department of Orthopaedics of Jiangsu Hospital of Integrated Traditional Chinese Medicine and Western Medicine,Nanjing 210028,Jiangsu,ChinaABSTRACT |
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| 谢林 |
XIE Lin |
江苏省中西医结合医院骨科,江苏 南京 210028 |
Department of Orthopaedics of Jiangsu Hospital of Integrated Traditional Chinese Medicine and Western Medicine,Nanjing 210028,Jiangsu,ChinaABSTRACT |
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| 黄海涛 |
HUANG Hai-tao |
江苏省中西医结合医院骨科,江苏 南京 210028 |
Department of Orthopaedics of Jiangsu Hospital of Integrated Traditional Chinese Medicine and Western Medicine,Nanjing 210028,Jiangsu,ChinaABSTRACT |
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| 陶永飞 |
TAO Yong-fei |
江苏省中西医结合医院骨科,江苏 南京 210028 |
Department of Orthopaedics of Jiangsu Hospital of Integrated Traditional Chinese Medicine and Western Medicine,Nanjing 210028,Jiangsu,ChinaABSTRACT |
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| 期刊信息：《中国骨伤》2010年23卷，第5期，第340-342页 |
| DOI：10.3969/j.issn.1003-0034.2010.05.006 |
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目的：分析动力髋螺钉(DHS)内固定治疗股骨转子间骨折失败的原因。
方法：总结分析1998年12月至2007年12月用DHS内固定治疗股骨转子间骨折78例，男42例，女36例；年龄26～85岁，平均62岁。入院距受伤时间1～49 h,平均4 h.按Evans-Jensen骨折分类标准，ⅠA型4例，ⅠB型24例，ⅡA型13例，ⅡB型22例，Ⅲ型11例，Ⅳ型反斜形骨折4例。按AO标准操作要求进行动力髋螺钉固定，术后凡出现股骨头切割、尾钉退出、髋内翻、螺钉松动、加压钉滑出套筒、大转子骨折移位均属失败，对其中失败的12例进行分类、归纳，分别分析其发生的原因。
结果：所有病例均获得随访，时间13个月～7年，平均36个月。12例失败，其中加压钉切割股骨头颈4例、髋内翻1例、加压钉滑出套筒2例、螺钉松动2例、尾钉外移2例、大转子骨折移位1例。
结论：DHS内固定是治疗股骨转子间骨折的有效方法，适应证的选择、患者骨骼的质量、手术医生的操作技术水平影响手术治疗的效果。 |
| [关键词]:股骨 髋骨折 骨折固定术,内 外科手术 |
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| Analysis of the treatment failures for intertrochanteric fractures with dynamic hip screw(DHS) |
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Abstract:
Objective: To analyze the reasons and related factors of failures in the treatment of intertrochanteric fracture with dynamic hip screw(DHS) and to increase the therapeutic level of intertrochanteric fracture.
Methods: All the 78 cases of intertrochanteric fractures were treated with dynamic hip screws from Dec.1998 to Dec.2007 included 42 males and 36 females with an average age of 62 years old ranging from 26 to 85 years. The diseace course was from 1 to 49 hours(means 4 hours). According to Evans-Jensen classification of intertrochanteric fracture,4 cases were type ⅠA,24 cases were typeⅠB,13 cases were type ⅡA,22 cases were type ⅡB,11 cases were type Ⅲ，4 cases were type Ⅳ。 The fracture were fixed with dynamic hip screws following AO operative standard. To analyze the reasons and related factors of the 12 failed cases involving femur head and neck cut-off,tail pin exit,coxa vara,screw loosening,compress screw slip out of the tube,fracture displacement,respectively.
Results: All the cases were followed up for 13 moths to 7 years with an average of 36 months,12 cases were failed including 4 cases of femur head and neck cut-off,1 case of coax vara,2 cases of compress screw slip out of the plate tube,2 cases of screws loosening,2 cases of tail pin displacement 1 case of great trochanter fracture displacement.
Conclusion: For intertrochanteric fracture,to interfix with dynamic hip screw is an effective method,the choice of indication,the type of fracture,the bone mineral density and the manipulative technique affect the results. |
| KEYWORDS:Femur Hip 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: | 周中,熊进,江宁,谢林,黄海涛,陶永飞.动力髋螺钉内固定治疗股骨转子间骨折失败原因分析[J].中国骨伤,2010,23(5):340~342 |
| 英文格式: | ZHOU Zhong,XIONG Jin,JIANG Ning,XIE Lin,HUANG Hai-tao,TAO Yong-fei.Analysis of the treatment failures for intertrochanteric fractures with dynamic hip screw(DHS)[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(5):340~342 |
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