微创动力髋螺钉与动力髋螺钉治疗高龄粉碎性股骨转子问骨折的疗效比较  

Comparison of MTDHS and DHS in treatment of comminuted intertrochanteric femur fractures

作　　者：童松林[1] 高益斌[1] 陆文杰[1] 虞建浩[1] 潘方[1] 潘志军[2] 

机构地区：[1]慈溪市人民医院骨科,315300 [2]浙江大学医学院附属第二医院骨科

出　　处：《中华创伤杂志》2010年第3期231-233,共3页Chinese Journal of Trauma

基　　金：宁波市医学科研计划资助项目（200560）

摘　　要：目的 探讨动力髋螺钉（DHS）和微创动力髋螺钉（MTDHS）治疗高龄粉碎性股骨转子间骨折的疗效.方法 2006年9月-2009年7月采用MTDHS和DHS分组治疗高龄粉碎性股骨转子问骨折42例.根据Evans分型：MTDHS组Ⅲ型16例,Ⅳ型6例;DHS组Ⅲ型15例,Ⅳ型5例.对手术时间、出血量、住院时间和髋关节功能进行评价.结果 42例患者术后随访9～17个月,平均13个月.髋关节功能按Harris评分标准进行评定：DHS组20例,平均76.4分,MTDHS组22例,平均89.8分.MTDHS组在手术时间、出血量和髋关节优良率方面均显著优于DHS组.结论 MTDHS治疗股骨转子间骨折,手术创伤小,术后髋关节功能恢复好,并发症发生率低,是治疗转子间骨折的较好方法.Objective To discuss the clinical effect of dynamic hip screw（DHS）and microtrauma dynamic hip screw（MTDHS）in treatment of comminuted intertrochanteric femur fractures in the elderly patients.Methods From September 2006 to July 2009,42 patients with comminuted intertrochanteric femur fractures were treated by DHS and MTDHS.According to Evans classification,there were 16 patients with type Ⅲ fractures and six with type Ⅳ fractures in MTDHS group and 15 patients with type Ⅲ fractures and five with type Ⅳ fractures in DHS group.The operation time,amount of bleeding,hospital stay and postoperative hip function were evaluated.Results All patients were followed up for 9-17 months（average 13 months）.Harris score was 76.4 points in 20 patients treated by DHS and 89.8 points in 22 patients treated by MTDHS,with better functional restoration,shorter operation time and less amount of bleeding in MTDHS group than DHS group.Conclusions Compared with DHS,MTDHS has advantages of minimal invasion,minor trauma,sound recovery of hip joint function and low incidence of complications and hence is a good choice for treating intertrochanteric femur fractures.

关 键 词：股骨骨折 动力髋螺钉 微创动力髋螺钉 

分 类 号：R687.3[医药卫生—骨科学]