动力髋螺钉治疗股骨粗隆间骨折并发症原因分析及防治.pdfVIP

中国骨伤 2oo8 年5 月第 21 卷第5 期 China J Orthop Trauma ,May.2oo8 ,Vo 1.21 ,No.5 .341. • 11笛扁豆习F员L· 动力髓螺钉治疗股骨粗隆间骨折并发症原因 分析及防治 郭金刚，郭金城，赵勇，王月光 (齐齐哈尔市肿瘤医院骨外科，黑龙江 齐齐哈尔 161∞2) [摘要] 目的:分析动力镜螺钉(DHS) 治疗股骨粗隆闯骨折并发症的原因，并提出防治措施。方法:对 65 例采用 DHS 治疗股骨粗隆间骨折患者中发生并发症 13 例进行临床总结，分析其发生的主要原因，提出相应的防治措施。其 中男 8 例，女 5 例;年龄 56-82 岁，平均 70.2 岁。结果: 13 例并发症中，术中股骨近端外侧皮质崩裂 2 例;术中镜螺钉穿 破股骨头进入镜臼 2 例:镜内翻 5 例;股骨头坏死 l 例;切口感染 3 例，其中 l 例出现骨折不愈合。结论:导量生并发症发 生的主要原因有手术操作不规范，无菌操作不严格，骨折复位不理想，术后过早负重。预防措施主要有严格元菌操作， 积极治疗内科疾病，规范手术操作，骨折尽量达到解剖复位，重视小粗隆及后内伽l 骨块的固定，术后合理进行功能锻 炼。 [关键词] 粗隆间骨折; 动力镜螺钉: 术后并发症 Complications of intertrochanteric fracture treated with dynamic hip screw: Cause anaIysis and prevention GUO ]in -gang , GUO ]in-cheng ,ZHAO Yong , WANG Yue-伊ang. Department of Orthopaedics ， Qiqì混aer Turrwr Hospìta1, Qiqihar 161∞2 ,Heilongjiang , China ABSTRACT Objective: To analyze causes of the complications in treatment of the intertrochanterìc fractures wi由 dynamic hip screw ( DHS )and discuss the way of the prevention. Methods: Sixty-five cases of intertrochanter fractures of femur were tre- ated with DHS. Among them ,the complications occurred in 13 cases ,their causes were analyzed and corresponding preventive treatments were discussed. 币le patients with complications included 8 male and 5 female ， and 由e mean age was 70.2 ye町S (range ,from 56ω82 years). Results:The m句。r complications of 13 cases included proximal femoral cortex broken in 2 cas- es ,femoral heads penetrated by screw in 2 ,varus deformity of hip in 5 ,necrosis of femoral head in 1,the wound infection ìn 3 (in- cluding bone non-union in 1). Conclusion: The main causes of the complications 缸e varìous as follows: the nonstandard oper- ative procedure ,incorrect aseptic measures ,unsatisfactory reduction , and too early weight bearìng. 币lerefore ， approprìate pre- ventive measures such