股骨髁锁定钢板逆行固定治疗股骨粗隆下骨折  

Surgical treatment of subtrochanteric femoral fractures with retrograde locking plate of femoral condyle

作　　者：毕刚[1] 欧毅[1] 黄祖成[1] 杨庆诚[2] 梅炯[1] 

机构地区：[1]同济大学附属同济医院骨科,上海200065 [2]上海交通大学附属第六人民医院骨科,上海200233

出　　处：《同济大学学报（医学版）》2011年第3期63-66,80,共5页Journal of Tongji University(Medical Science)

摘　　要：目的探讨应用股骨髁锁定钢板逆行固定治疗股骨粗隆下骨折的临床疗效,分析临床应用股骨髁锁定钢板治疗股骨粗隆下骨折的可行性。方法自2007年3月—2009年12月,我科共应用股骨髁钛合金锁定钢板逆行固定治疗股骨粗隆下骨折20例。按Seinsheimer分型,本组病例中ⅡB型1例,ⅡC型3例,ⅢA型3例,ⅢB型3例,Ⅳ型6例,Ⅴ型4例。结果所有患者的切口均获Ⅰ/甲愈合,并且所有患者均能在康复医师的指导下进行早期的髋关节功能锻炼,住院期间未出现感染、褥疮、深静脉血栓、内固定松动,断裂等并发症。所有患者均获至少一次的随访,时间从10个月到24个月不等,平均(16.2±6.6)个月。患者的预后根据髋关节Harris评分进行评估,其中优9例;良7例、可4例;差0例。优良率为80%。结论应用股骨髁锁定钢板逆行固定治疗股骨粗隆下骨折,可使股骨粗隆部达到坚强固定的效果,并可使髋关节进行早期功能锻炼,且能有效减少长期卧床并发症的发生,达到较理想的临床疗效,适合临床使用。Objective To evaluate the therapeutic effect of retrograde locking plate of femoral condyle in treatment of subtrochanteric femoral fractures and to analyze the feasibility of the clinical application of the retrograde locking plate of femoral condyle in the treatment of the subtrochanteric femoral fractures. Methods Twenty patients with subtrochanteric femoral fractures were treated with retrograde locking plate of femoral condyle from Mar. 2007 to Dec. 2009. According to the Seinsheimer classification system, 1 case was in type Ⅱ B, 3 cases in type Ⅱ C, type Ⅲ A and type m B respectively, 6 cases in type IV and 4 cases in type V. Results All incisions were healed by first intention and all cases did early rehabilitation exercises in hip joint, with the guidance of physical therapist. No complications occurred during hospitalization, including infections, decubital ulcer, deep vein thrombus, internal fixation loosening or breakage. Patients were followed-up for 10 to 24 months, mean（ 16.2±6.6）months. According to the Harris scoring system, the outcome of patients was excellent in 9 cases, good in 7 cases, fair in 4 cases with the excellent and good rate of 80% and no cases was classified as poor. Conclusions The retrograde locking plate of femoral condyle can provide rigid fixation in subtrochanteric femoral fractures, which enables early rehabilitation with less complication. It is an ideal method in treating subtrochanteric femoral fractures.

关 键 词：股骨髁锁定钢板 股骨粗隆下骨折 内固定 

分 类 号：R683.42[医药卫生—骨科学]