双头自动加压新型外固定支架的设计和临床应用  

Design and clinical application of new type two-head automatic pressure external fixation (TAPEF)

作　　者：秦玉星[1] 蔡浩[1] 黄永辉[2] 陈广祥[3] 盛国庆[1] 姜林忠[1] 

机构地区：[1]丹阳中医院骨伤科,江苏丹阳212300 [2]江苏大学附属医院骨科 [3]苏州市立医院骨科

出　　处：《中国骨伤》2012年第2期165-168,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:设计股骨转子间骨折双头自动加压新型外固定支架并探讨其临床应用。方法:在单侧成角外固定器和Ilizarov技术的基本原理的基础上,研制双头自动加压新型外固定支架。2006年10月至2010年12月,用此新型外固定器治疗老年股骨转子间骨折120例,男67例,女53例;年龄60～93岁,平均76.7岁。按Evans标准:Ⅰ型65例,Ⅱ型41例,Ⅲa型10例,Ⅲb型2例,Ⅳ型2例。手术时间为伤后0～11d,平均5d。按照Sanders评分标准对术后患者的髋关节功能进行评估。结果:116例获得随访,时间2～24个月,平均12个月。骨折全部愈合,愈合时间10～13周,平均12周。术后针孔感染5例,无深部感染发生,无骨折不愈合及髋内翻,髋关节功能恢复良好。根据Sanders评分标准对髋关节功能进行评定,疼痛(9.07±0.41)分,行走(9.23±1.00)分,功能(9.42±1.10)分,运动肌力量(9.31±1.06)分,日常活动(9.22±1.03)分,X线评估(10.00±0.00)分,总平均分(56.27±4.16)分,其中优106例,良6例,差4例。结论:双头自动加压外固定器使用方便,兼有加压和微创双重功能,是治疗高龄股骨转子间骨折患者较理想方法。Objective：To design a new type two-head automatic pressure external fixator and explore its clinical effects in treating intertrochanteric fracture of the femur. Methods：Base on unilateral angulated external fixator and Ilizarov techiques,a new type two-head automatic pressure external fixator were designed and made. From October 2006 to December 2010,120 patients with intertrochanteric fracture of the femur were treated with the new type two-head automatic pressure external fixator. There were 67 males and 53 females with an average age of 76.7 years（ranged,60 to 93 years）. According to Evans classification,typeⅠwas in 65 cases,typeⅡin 41,typeⅢa in 10,typeⅢb in 2 and typeⅣin 2. Operative time was from 0 to 11 days after injury with an average 5 days. Postoperative functional recovery was evaluated according to criteria of Sanders. Results：Among 120 patients,116 cases were followed up with an average of 12 months（ranged,2 to 24 months）. All fractures obtained healing with average healing time of 12 weeks（ranged,10 to 13 weeks）. Five cases occurred with superficial infection of pin site and no deep infection,non-union,coxa adducta were found. Joint function of hip recovered well. According to Sanders scoring,pain,walking,function,muscle strength,daily activities and X-ray estimate were respectively（9.07±0.41）,（9.23±1.00）,（9.42±1.10）,（9.31±1.06）,（9.22±1.03）,（10.00±0.00）with total amount of （56.27±4.16）. A hundred and six cases got an excellent results,6 good,4 poor. Conclusion：The new type two-head automatic pressure external fixator is easy and convenient to apply in operation. It has duplicate functions of load and minimal invasive. It is an ideal method for treatment of the intertrochanteric fracture of the femur in high-risk and senile patients.

关 键 词：转子间骨折 股骨 牵引术 外固定器 

分 类 号：R683.42[医药卫生—骨科学]