股骨近端创伤的生物力学和临床研究骨科学专业论文.docxVIP

股骨近端创伤的生物力学和临床研究 股骨近端创伤的生物力学和临床研究 英文提要 SUMMARY objective：To introduce an intemal fixation of the latest design for peritrochanteric fracture(PF)，a new device for clinical application，called Bi一 (． axis Sliding Instrument(BSI)；Summary the clinical results of femoral neck fracture treated with dynamic compression screw(DeS)．Analyse factors related to the clinical results and the failure of treatment．Methods：Apply BSI to biomechanical tests and clinical test．To retrospectively analyse cases who are treated with DCS and the failure cases of treatment in the femoral neck fracture with internal fixation．Results：BSI has more excellent results in biomechanical testes．BSI and DCS all have satisfied clinical results．Fracture type，reduction quality,age，the time of starting weight carrying are co．elated with the prognosis；The failure of treatment in the femoral neck fracture closely related to the pre—operative，operative，post—operative incorrect iatrogenic factors Conclusion：BSI and DCS can be applied safely widely to clinical．The principles for the treatment of femoral neck fracture are anatomic reduction and rigid fixation and late weight carrying；Pay attention to factors related to the failure oftreatment in the femoral neck fracture Key Words：peritrochanteric femoral neck fracture related factors failure Written by Zhou Feng Supervised by Prof．Tang Tian—si 股骨近端刨伤的生物力学和临床研究 股骨近端刨伤的生物力学和临床研究 引言 引 言 20世纪30、40年代有学者提出了手术方法治疗股骨转子部骨折 (Thornton 1937，Jewett 1941，Mclaughlin 1947)11-31。但是直至40年代 末50年代初骨牵引保守治疗仍为股骨转子部骨折治疗的最常用手段。手 术治疗可使患者早期活动，提高治愈率，随着人们对该优越性的逐步认识， 内固定手术治疗得到了普遍认可(Boyd and Griffin 1949，Evans 1949，1951， Holt 1963，等)[4-71。但是随之而来的是一些手术并发症出现，如钉或针 穿出股骨头、颈：钢板折弯、断裂：骨不连等，这些内固定失败率在不稳 定PF治疗中可高达20．50％(Clawson 1964，Jensen et ai，1980，Jaeobs et al， 1976，Heyse