髓内固定治疗转子间骨折柔和复位技巧.docVIP

髓内固定治疗转子间骨折柔和复位技巧 　　摘 要：目的 探讨髓内固定治疗股骨转子间骨折的柔和复位技巧，以实现满意复位，为临床提供参考。方法 自2015年7月～2017 年7 月对152例股骨转子间骨折患者行髓内钉治疗，以探讨股骨转子间骨折的柔和复位技巧，其中87例采用牵引床闭合复位，对于单纯闭合复位未能完成良好复位的，采用克氏针/“金手指”/骨钩/点状复位钳/主钉/“分段预置钉道”等方法辅助复位。结果 67例获得解剖复位，85例获得可接受复位，术后随访6～12 y，骨折均愈合。结论 根据骨折的类型和术中状况，运用各种柔和的复位技巧尽可能实现满意复位可减少相关并发症的发生，从而获得更好的疗效。 　　关键词：股骨转子间骨折；髓内钉；复位技巧 　　中图分类号：R683.42 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.01.002 　　文章编号：1006-1959（2018）01-0004-04 　　Intramedullary Fixation for the Treatment of Intertrochanteric Fracture Reposition Techniques 　　CHU Bin，TANG Jian，LI Guang-yu，ZHOU Jian，LU Xiao-lin 　　（Department of Orthopedics，the First Affiliated Hospital of Anhui Medical University，Hefei 230032，Anhui，China） 　　Abstract：Objective To explore the soft reduction technique of intramedullary fixation in the treatment of intertrochanteric fractures in order to achieve satisfactory reduction and provide a reference for clinical practice.Methods 152 patients with femoral intertrochanteric fractures were treated with intramedullary nailing to explore the soft reposition techniques of intervertebral intertrochanteric fractures from July 2015 to July 2017.Among them，87 patients were treated with traction bed closure and closed reposition.For simple closed reduction fails to complete the good reduction，using Kirschner wire/gold finger bone/hook/point/main/nail clampsection preset screwmethod.Results 67 cases of assisted reduction to obtain anatomic reduction，85 cases obtained acceptable reduction，postoperative follow-up of 6～12 months，all fractures healing.Conclusion According to the type and status of fracture in the use of various soft reduction techniques as much as possible to achieve satisfactory reduction can reduce the complications，in order to obtain better curative effect. 　　Key words：Femoral intertrochanteric fractures；Intramedullary nailing；Resetting skills 　　近年?恚?股骨转子间骨折（intertrochanteric fractures of femur）的发病率在老年骨折中逐年增高。该类患者常合并有骨质疏松、心脑血管等多个系统的基础疾病，临床上当患者无明确手术禁忌证时，优先选择手术治疗。股骨转子间骨折的手术方式有很多，