应用γ钉治疗转子间骨折的并发症  

Complications of gamma nail treatment of intertrochanteric fractures

作　　者：段德宇[1] 杨述华[1] 郑启新[1] 邵增务[1] 王洪[1] 刘勇[1] 叶哲伟[1] 杨操[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院骨科,武汉430022

出　　处：《中国微创外科杂志》2007年第7期638-640,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的 探讨应用γ钉治疗转子间骨折并发症的原因。方法 2000年1月～2004年12月,我院应用γ钉治疗转子间骨折76例,随访1年以上,13例出现并发症,发生率为17.1%（13/76）。参照Evans分型,Ⅲ型6例,Ⅳ型7例。结果 骨折延迟愈合1例,肺部感染2例,泌尿道感染1例,深静脉血栓1例,褥疮1例,拉力螺钉穿透股骨头2例,继发性股骨骨折1例,髋内翻3例,远端螺钉放置失败1例;无主钉或锁钉断裂等并发症发生。经相应处理,均获得骨性愈合。结论 应用γ钉治疗转子间骨折,并发症的出现是由多方面原因所致,但只要早发现、及时正确地处理,一般能获得良好的预后。Objective To analyze the complications of gamma nail treatment for intertrochanteric fractures. Methods A total of 76 cases of intertrochanteric fractures was treated with a gamma nail from January 2000 to December 2004 in this hospital. According to the Evans＇ classification, there were 6 cases of type Ⅲ and 7 cases of type Ⅳ. During a follow-up for more than 1 year, complications developed in 13 cases （17.1% , 13/76）. Results There were 1 case of delayed bone union, 2 cases of pulmonary infection, 1 case of urinary tract infection, 1 case of deep vein thrombosis, 1 cases of decubital ulcer, 2 cases of screw penetrating the femoral head, 1 case of secondary femoral fracture, 3 cases of coxa vara, and 1 case of failed placement of distal screw. There was no break of the nails or the lock pins. A bone union was obtained after further corresponding treatment in all the cases. Conclusions Various causes may lead to complications after gamma nail treatment for intertrochanteric fractures. We can achieve satisfactory prognosis by early diagnosis and prompt and proper treatment.

关 键 词：转子间骨折 Γ钉 并发症 

分 类 号：R683.42[医药卫生—骨科学]