DCS治疗股骨转子间骨折的临床疗效及其适应证研究  

Clinical evaluation and indications of dynamic condylar srew for intertrochanteric fractures of femur

作　　者：许国富 胡正军 张亦俊 郭建军 

机构地区：[1]镇江市丹徒区人民医院骨科,江苏镇江212003

出　　处：《医药论坛杂志》2011年第21期6-8,共3页Journal of Medical Forum

摘　　要：目的研究动力髁螺钉(Dynamic condylar screw,DCS)治疗股骨转子间骨折的临床疗效和并发症以探讨其适应证。方法回顾性分析2002年至2010年在镇江市丹徒区人民医院骨科行股骨转子间骨折切开复位DCS固定且有完整随访资料的股骨转子间骨折患者68例,按照Evans分型分为ⅠA 4例,ⅠB 13例,ⅠC 22例,ⅠD 18例,Ⅱ型11例。对不同分型的骨折术后疗效及并发症进行分析。结果所有患者平均随访15个月,68例患者均获得骨性愈合,根据Radford标准术后临床疗效48例优,14例良,4例中,2例差,总体优良率为91.2%。1例术后发生脑梗,5例发生髋内翻,4例出现肢体短缩,1例出现轻度旋转畸形。结论 DCS对于不同Evans分型的股骨转子间骨折可获得良好的治疗效果,可作为股骨转子骨折的常规选择,但术中需注意小转子的复位和内侧结构的重建。Objective To analyze the clinical efficacy and the complications of Dynamic Condylar Srew（DCS） treated for intertrochanteric fractures of femur.Methods Sixty-eight femur intertrochanteric fracture patients（mean age 14 years old） who received open reduction and internal fixation from 2002 to 2010 in one institution were evaluated.The patients were classified according to the Evans Type：ⅠA in 4,ⅠB in 13,ⅠC in 22,ⅠD in 18,Ⅱin 11.The postopretive clinical efficacy and the complication of different type of fracture was studied.Results With a mean follow-up of 15 months,Union was achieved in all cases.There were 48 excellent,14 good,4 fair and 2 poor results.Stroke was occurred in 1 case,and there was varus in 5 cases,limb length discrepancy（mean 1 cm） in 4 cases and rotational deformity in 1 case.Conclusions For different type of femur intertrochanteric fracture,excellent clinical evaluation could be achieved with DCS implant.It can be relied upon to treat all types of intertrochanteric fracture.However,the reduction of lesser trochanter and the reconstruction of good medial support is vital.

关 键 词：DCS 股骨 转子间骨折 

分 类 号：R683.42[医药卫生—骨科学]