DHS和LCP内固定治疗青壮年股骨粗隆间骨折  

The Treatment of Intertrochanteric Fractures with DHS and LCP in Young Adults

作　　者：沈宁江[1] 王广积[1] 林坚平[1] 黎早敏[1] 林明侠[1] 林庆彪[1] 

机构地区：[1]海南省人民医院骨科中心,海南海口570311

出　　处：《实用骨科杂志》2014年第4期312-314,共3页Journal of Practical Orthopaedics

摘　　要：目的 比较动力髋螺钉（dynamic hip screw,DHS）和解剖型锁定钛板（locking compression plate,LCP）内固定治疗青壮年股骨粗隆间骨折的疗效.方法 151例青壮年股骨粗隆间骨折中DHS治疗62例,LCP治疗89例.其中男112例,女39例;年龄19 ～ 59岁,平均40.5岁.车祸伤74例,坠落伤51例,摔伤26例,均为闭合性骨折.结果 DHS、LCP组手术时间、术中出血量、卧床时间及骨折愈合时间相当,差异无统计学意义（P＞0.05）,但末次随访Harris 评分优良率LCP高于DHS组,差异有统计学意义（P＞0.05）.结论 LCP的疗效优于DHS,DHS只适用于稳定型股骨粗隆间骨折,对于不稳定型骨折,应选用LCP固定.青壮年患者不遵医嘱术后早期负重,是术后失败的主要原因,故术后功能锻炼要遵循“早活动,晚负重”的原则,待骨折端有明显骨痂形成后方可完全负重.Objective To compare the efficacy of dynamic hip screw （DHS） and anatomical locking compression plate （LCP） in treating intertrochanteric fractures of young adults.Methods 151 young adults patients with intertrochanteric fracture underuent surgery,with 62 cases of DHS and 89 cases of LCP respectively.Results The averaged operative time,blood loss,bed rest time and bone union time were similar in two groups,with the difference not statistically significant（P ＞0.05）.According to Harris assessment criteria,the excellent and good rate of LCP group at final follow-up time was better than that of the DHS group,with the differences statistically significant（P ＜ 0.05）.Conclusion The clinical efficacy of LCP internal fixation method was more effective than DHS.DHS method is only applicable to stable intertrochanteric fractures.As for unstable fractures types,LCP fixation method should be used.The main reason of postoperative internal fixation failures in young adults patients lied in disobedience by early postoperative weight bearing.Therefore,the principle of ＂early activity,late load＂ should be followed in postoperative functional exercise.Full weight bearing should be carried out only after a significant callus formation in fractured sites.

关 键 词：股骨粗隆间骨折 内固定 动力髋螺钉 解剖型锁定钛板 青壮年 

分 类 号：R683.42[医药卫生—骨科学]