动力髁螺钉内固定治疗股骨粗隆下骨折的临床分析_临床医学论文.docVIP

动力髁螺钉内固定治疗股骨粗隆下骨折的临床分析_临床医学论文 动力髁螺钉内固定治疗股骨粗隆下骨折的临床分析_临床医学论文 【摘要】 评估动力髁螺钉（Dynamic condylar screw DCS）内固定治疗股骨粗隆下骨折的临床价值。［方法］回顾性分析29例股骨粗隆下骨折患者，男18例,女11例，平均年龄52.2岁；车祸伤7例，坠落伤8例，跌伤14例；骨折按照Seinsheimer分类,Ⅱ型5例(ⅡB 型2例、ⅡC 型3例)、Ⅲ型12例( ⅢA 型7 例、ⅢB 型5例) 、Ⅳ型5例、Ⅴ型7例。手术方式均采用切开复位动力髁螺钉固定。所有病例随访9～24个月,平均16个月，随访内容包括Sanders髋关节功能评分及手术相关并发症。［结果］骨折均骨性愈合，愈合时间平均3.5个月（3～5个月），仅1例患者术后16个月骨折愈合后因外伤发生钢板断裂并粗隆间再次骨折。术后可早期进行患肢功能锻炼及无负重下地活动。未出现感染、髋内翻畸形、内固定松动等并发症。按Sanders髋关节功能评分系统评分，优（55～60分）18例，良（45～54分）10例，差（35～44分）1例，优良率96.5%。［结论］动力髁螺钉治疗股骨粗隆下骨折，复位满意，固定牢靠，可有效避免股骨缩短、旋转及髋内翻畸形，具有疗效好、康复快、功能恢复满意等优点，是治疗股骨粗隆下骨折可选择的理想治疗方法之一。 【关键词】 动力髁螺钉 股骨粗隆下骨折 内固定 Abstract：［Objective］To evaluate the clinical value in treatment of subtrochanteric fracture of the femur by dynamic condylar screw（DCS）.［Method］This study retrospectively reviewed 29 patients who suffered from subtrochanteric fracture of the femur．There were 18 males，11 females，with an average age of 52.2 years．Seven cases were caused by traffic accident，8 cases caused by falling from hight，14 cases caused by pedestrian injury.According to Seinsheimer classification，there were 5 cases of typeⅡ(2 of typeⅡB，3 of typeⅡC)，12 cases of typeⅢ (7 of type ⅢA,5 of type ⅢB )，5 cases of type Ⅳ，7 cases of type Ⅴ．All patients accepted the treatment with traction reduction and dynamic condylar screw fixation and were fellowed up for 9～24 months (average 16 months)．Outcoms were assessed by Sanders traumatic hip rating scale and postoperative complications were analyzed．［Result］All patients obtained bone union in average 3.5 months (3～5 months),Only one case who had obtained bone union suffered subtrochanteric refracture 16 months after operation because of plate breakage.All patients were encouraged to early exercise and walk by nonweight-bearing.There was no postoperative infection，deep venous thrombosis,internal fixation loosening,limb shortening and varus deformity．According to sanders traumatic hip rating scale，18 cases were excellent，10 cases were good，1case was fair.The excel