股骨转子间粉碎骨折小转子复位与未复位对发生髋内翻影响的临床研究  

The cinical studies of the impact of CoxaVara using bone Reset and not reset to intertrochanteric comminuted fractures

作　　者：王国胜[1] 曹力[1] 

机构地区：[1]新疆医科大学第一附属医院关节外科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2014年第2期195-198,共4页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(2011211A044)

摘　　要：目的：探讨股骨转子间粉碎性骨折小转子复位与未复位对患者术后髋内翻的影响。方法选择新疆医科大学第一附属医院关节外科2009年6月-2012年2月采用动力髋螺钉（DHS）治疗股骨转子间粉碎性骨折的患者53例，6例患者失访，对资料完整的47例患者资料进行分析，患者年龄65～83岁，平均74．6岁，其中男性21例，女性26例；小转子复位组19例，未复位组28例；Evans 分型Ⅲ型23例，Ⅳ型18例，V 型6例。对比两组颈干角丢失的度数、骨折愈合的时间、髋关节功能。结果47例患者随访时间1～1．5 a，平均为17．3个月。小转子复位组与未复位组颈干角丢失度数（6个月末）、骨折愈合时间、髋关节功能（平均 Harris 评分）比较差异有统计学意义（P 均＜0．05）。结论小转子复位不但可以增加骨折的稳定性，而且可以减少 DHS 内固定所承受的应力，并发症少，术后髋关节髋内翻的发生率低。Objective To explore the impact of CoxaVara after surgery using Reset and not reset internal fixation with intertrochanteric comminuted fractures.Methods 53 patients with proximal femoral fractures were retrospectively collected from June.2009 to Feb.2012.6 patients were lost to follow,so the only complete 47 examples were analyzed,including 21 males and 26 females aged from 65-83 years,of which there were 19 cases of small rotor reset,28 cases of not reset;23 cases of Evans Ⅲ type,18 cases ofⅣ type,6 cases of V type,comparing the degree of loss of neck shaft angle,fracture healing time,and the function of Hip Joint.Results 47 patients were followed up for 1~1.5 a,an average of 17.3 months.A small group reset and not reset rotor group lost in neck shaft angle in degrees （six at the end）,fracture healing time （w ）, hip function （average Harris hip score ） and the difference was statistically significant （P ＆lt;0.05）.Conclusion Lesser trochanter reset could not only increase the stability of the frac-ture,but also reduce the stress of DHS fixation,the complications and the incidence of postoperative hip varus.

关 键 词：股骨转子间骨折 DHS 复位 治疗 

分 类 号：R684[医药卫生—骨科学]