倒置LISS钢板治疗累及股骨干的不稳定性股骨转子间及转子下骨折  

Inversive LISS plate in treating intertrochanteric and subtrochanteric fractures combined with femoral shaft fractures

作　　者：韩雷[1] 胡云根[1] 方伟利 金波[1] 许世超[1] HAN Lei HU Ynn-gen FANG Wei-li JIN Bo XU Shi-chao(Traditional Chinese Medical Hospital of Xiaoshan, Hangzhou 311201, Zhejiang, Chinese)

机构地区：[1]浙江中医药大学附属江南医院杭州市萧山中医院,浙江杭州311201

出　　处：《中国骨伤》2017年第7期612-615,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的 :探讨倒置LISS(less invasive stabilization system)钢板治疗累及股骨干的不稳定性股骨转子间及转子下骨折的临床疗效。方法:回顾性分析2012年1月至2015年1月收治的24例累及股骨干的不稳定性股骨转子间及转子下骨折患者,男16例,女8例;年龄35~81岁,平均62.5岁。受伤原因:交通伤8例,高处坠落伤3例,摔伤13例。受伤至手术时间2~12 d,平均5.2 d;采用倒置LISS进行治疗,随访时拍摄股骨正侧位X线片。记录患者的手术时间、术中出血量、住院天数,术后疗效评价采用Harris髋关节功能评分标准。结果:24例均获随访,时间18~36个月,平均16.2个月。手术时间(68.22±48.36)min,术中出血量(256.28±182.46)ml,住院天数(14.8±5.2)d。全部病例获得骨性愈合,平均愈合时间4.8个月(3~8个月)。未发生深部感染、下肢深静脉血栓、肺栓塞、骨不连等并发症。末次随访时Harris评分为76.49±12.28,其中优15例,良6例,可3例。结论:倒置LISS钢板治疗累及股骨干的不稳定性股骨转子间及转子下骨折疗效满意,术后需严格随访,不应强调过早负重。Objective：To study clinical effects of inversive LISS（less invasive stabilization system,LISS） plate for the treatment of intertrochanteric and subtrochanteric fractures combined with femoral shaft fractures. Methods：From January2012 to January 2015,24 patients with intertrochanteric and subtrochanteric fractures combined with femoral shaft fractures were treated with inversive LISS plate,included 16 males and 8 females with an average age of 62.5 years old ranged from 35 to81 years old. There were 8 cases of traffic accident injuries,3 cases of falling from high place,and 13 cases of falls injuries. The time from injury to operation was ranged from 2 to 12 days with an average of 5.2 days. The operation time,intraoperative blood loss and the length of hospitalization were analyzed. The fracture union was assessed by follow up radiographs and hip functional recovery by Harris hip scoring. Results：All patients were followed up for 16.2 months（ranged,18 to 36 months）. The mean operative time was（68.22±48.36） min;the mean blood loss was（256.28±182.46） ml;the mean time of hospitalization was（14.8±5.2） days. There were no complications such as deep infection,deep vein thrombosis,pulmonary embolism and bone nonunion during the follow up period. The bone healing was ranged from 3 to 8 months with an average of 4.8 months. The mean Harris score was 76.49±12.28 at the final follow up,15 cases were classified as excellent,6 as good and 3 as fair. Conclusion：Inversive LISS plate can be used in treating with intertrochanteric and subtrochanteric fractures combined with femoral shaft fractures,and should not emphasis on premature loading.

关 键 词：股骨骨折 骨折固定术 内 外科手术 

分 类 号：R683[医药卫生—骨科学]