摘要
目的探讨应用动力髁螺钉(dynamic condylar screw,DCS)治疗股骨近端不稳定骨折的方法,评价其术中、术后情况及临床疗效。方法自2004年1月至2009年6月采用闭合复位动力髁螺钉内固定治疗股骨近端骨折37例,其中男15例,女22例;股骨逆粗隆间骨折16例,股骨粗隆下骨折21例。在患者平均年龄、体重指数、手术时间、术中失血量、X线投照次数、术中及术后输血量、术后伤口引流量、术后颈干角、骨折愈合时间(患者开始完全负重时间)等方面进行统计,并进行Harris评分。结果 37例中34例得到6～60个月的随访,骨折全部愈合,无断钉、断板、骨不连等并发症。Harris评分为优15例,良12例,中4例,差3例,优良率79.41%。结论 DCS能有效治疗股骨近端不稳定骨折,但对于高龄、肥胖患者是否应用应权衡利弊,如必须选用DCS则需适当延长术后开始负重以及完全负重时间。
Objective To evaluate the efficacy of operative treatment for the Proximal femoral fracture with dynamic condyle screw（DCS）.Methods From January 2004 to June 2009,37 cases of patients with Proximal femoral fracture（Reverse intertrochanteric femur fractures in 16 cases,21 cases of intertrochanteric fracture;Male 15,Female 22） was treated by DCS.34 cases were followed up by 6 to 60 months in average age.The body mass index,operative time,blood loss,X ray projection times,the number of postoperative blood transfusion,postoperative wound drainage,postoperative neck-shaft angle,fracture healing time（patient began full weight bearing time） was statistics,and make Harris score.Results All patients were healed and there are no complications such as broken nails,broken boards,and other nonunion take place.32 patients were followed up for 11～24 months time,with an average of 13 months.According to Harris score,the result was excellent in 15 cases,good in12 cases,fair in4 and not satisfied with3.The excellent rate is 79.41%.Conclusion Dynamic condylar screw is effective methods in treating unstable proximal femoral fractures.Application of DCS should be considered in elderly,obese patients.If you have to use the DCS,full weight-bearing should be extended.
出处
《实用骨科杂志》
2011年第2期120-122,共3页
Journal of Practical Orthopaedics
基金
亚洲创伤骨科学会(AADO)资助项目(AADO-2009-082)
关键词
动力髁螺钉
股骨近端骨折
骨折固定术
dynamic condylar screw
proximal femoral fractures
fracture fixation
