动力髋螺钉钢板辅以阻挡钉治疗股骨转子间骨折  

Dynamic hip screw plates assisted with blocking screws for treatment of intertrochanteric fracture

作　　者：陈鹏[1] 朱国兴[1] 杨玉生[1] 陈刚[1] 石磊[1] 

机构地区：[1]无锡市第二人民医院骨科,214000

出　　处：《中华创伤杂志》2013年第4期338-340,共3页Chinese Journal of Trauma

摘　　要：目的探讨动力髋螺钉（dynamic hi pscrew，DHS）钢板辅以阻挡钉治疗股骨转子间骨折的疗效。方法选择150例股骨转子间骨折患者作为联合治疗组，即在进行DHS内固定的基础上，紧邻主钉下方平行打入阻挡钉1枚以增强稳定性，同时阻挡钉尾部搁在钢板上。选择单独应用DHS固定患者87例作为对照组，对两组手术效果进行对比研究。结果联合治疗组手术固定良好，无股骨颈外移、主钉在股骨头切割、骨折不愈合的患者，无死亡患者。术后所有患者日常生活能自理，无严重疼痛、功能障碍，优良率为98．7％，显著高于对照组（P〈0．01），而手术失败率显著低于对照组（P〈0．05）。结论DHS辅以阻挡钉治疗股骨转子间骨折，固定可靠，疗效确切，有利于骨折的稳定和早期功能锻炼，术后的并发症发生率低，是治疗股骨距内侧壁不完整的股骨转子间骨折的理想治疗方法之一。Objective To investigate effects of dynamic hip screw （DHS） fixation assisted with blocking screws in treatment of intertrochanteric fracture. Methods A total of 150 patients with intertrochanteric fracture were selected as the combined treatment group, of which the patients managed by DHS internal fixation were followed by the parallel placement of a blocking screw closely beneath the main screw for stability with its end rested on the plate. Another 87 patients managed by DHS fixation alone were determined as the control group. The surgical outcomes of the two groups were analyzed and compared. Results Good fixation without external displacement of femoral neck and cut-out of the main screw in femoral head was achieved in the combined treatment group. Also, fracture nonunion or death did not exist in the combined group. The patients in combined treatment group could take care of themselves after operation in the absence of severe pain and functional disturbance, with higher excellence rate （98.7%） than that in control group （ P 〈 0.01 ）. Whereas, the operation failure rate was significantly lower in combined treatment group than in control group （ P 〈 0.05 ）. Conclusion DHS fixation assisted with blocking screws is an ideal treatment of incomplete intertrochanteric fracture in medial wall of calcar femorale for it can achieve reliable fixation and definite curative effect, favor fracture healing, early functional exercise and low incidence of postoperative complications.

关 键 词：股骨 髋骨折 疗效比较研究 

分 类 号：R687.3[医药卫生—骨科学]