回顾性分析解剖型股骨近端锁定加压钢板在不稳定股骨上段骨折中的临床应用  

The proximal femoral locking compression plate in the clinical application of unstable proximal femur fractures:a retrospective analysis

作　　者：虞海涵 李明辉 刘洋 

机构地区：[1]湖北省黄石大冶市第二人民医院,湖北黄石435119 [2]湖北省武汉市第五医院骨科,湖北武汉430050

出　　处：《生物骨科材料与临床研究》2015年第6期48-50,53,共4页Orthopaedic Biomechanics Materials and Clinical Study

基　　金：亚洲创伤骨科学会(AADO)基金资助(AADO-RF2009-004-2Y)

摘　　要：目的回顾性探讨分析解剖型股骨近端锁定加压钢板治疗不稳定的股骨上段骨折中的临床疗效和并发症。方法对2010年1月-2013年6月共27例股骨上段骨折的患者采用解剖型股骨近端锁定加压钢板治疗,术前X片及CT三维成像评估骨折类型,其中粗隆间骨折16例（AO 31 A1型3例,A2型7例,A3型6例）,粗隆下骨折11例（SeinsheimerⅡ型2例,Ⅲ型2例,Ⅳ型4例,Ⅴ型3例）,记录患者年龄,性别,手术时间、术中失血及输血量。术后采用Harris评分,借助X线结合临床进行疗效、并发症的评估。结果 27例患者均获随访,时间（18±6.5）月（10-24月）。术中统计手术时间为（73.5±22）分钟（55-110分钟）,术中失血量平均为（312.4±21）m L（150-850m L）。围手术期无严重并发症或原有合并症加重,复查X片示颈干角（122±12）°（110-145°）,27例患者均获骨性愈合,骨折临床愈合时间（14±2.5）周（11-19周）。末次随访时髋关节功能按Harris评分标准评定为（80.6±10.4）分,其中优11例,良9例,可5例,差2例,优良率74.07%,1例出现髋内翻畸形。结论股骨近端锁定加压钢板治疗不稳定股骨上段骨折具有并发症少,内固定牢固,骨折愈合率高等优点,适用于特殊类型的股骨上段骨折,但其长期疗效仍需大样本、多中心观察。Objective Retrospective study and analysis of the clinical efficacy of the treatment of proximal femoral fractures by Proximal femoral locking compression plate. Methods From January 2010 to June 2013, the Anatomical Proximal femoral locking compression plate were applicated to treatment of 27 cases of patients with Proximal femoral fracture. 27 cases of patients were classified by 16 case of intertrochanteric fractures and 11 cases of subtrochanteric fractures. We make the statistics on age, sex, intraoperative blood loss, operation time, and make evaluation of the efficacy of postoperative, complications by the Harris hip score. Results 27 patients were followed up for（18±6.5）（10 to 24） months.Statistics show that the average operation time was 73.5 min（55 to 110 min）,the average intraoperative blood loss was（312.4±21） m L（150 to 850 m L）. The results show that the neck shaft angle was（122±12） °（110 to 145°）, fracture healing time was（14±2.5） weeks（11 to 19 weeks）, the hip Harris score was（80.6±10.4） points, among which were excellent in 11 cases, good in 9 cases, morderate in 5 cases and poor in 2 cases, good rate of 74.07%. There were just one hip varus deformity. Conclusion The proximal femoral locking compression plate have the advantages of firmly fixed,fewer complications, and clinical efficacy to treatment of proximal femoral fractures, but its long-term efficacy are needed large sample and multi-center observation.

关 键 词：股骨上段 骨折 股骨近端解剖钢板 内固定 

分 类 号：R687.3[医药卫生—骨科学]