摘要
目的:探讨股骨转子间骨折髓内固定失败的相关因素及其对失败预测的有效性。方法:收集2006年至2010年于我院行闭合复位Gamma钉内固定的股骨转子间骨折患者的临床资料,回顾性分析骨折复位情况、尖顶距(TAD)及拉力螺钉在股骨头颈内的位置3个因素对失败预测的有效性。结果:纳入研究的249例病例,失败共21例,失败率为8.4%。切出组患者平均TAD 35 mm,未切出的患者平均TAD 24 mm。TAD是一个比较可靠的预测内固定失败的因素。内侧皮质复位情况及是否髋内翻与内固定失败相关。拉力螺钉置于股骨头颈的中下区域能有效防止螺钉切除。结论:闭合复位时尽量复位内侧皮质并避免髋内翻,将拉力螺钉置于股骨头中下区域能有效预防内固定失败,尖顶距能有效预测术后失败风险。
Objective： To discuss the risk factors related to internal fixation for intertrochanteric fracture and investigate reliability of these factors as predictors for screw cutout.Methods： All patients with an intrertrochanteric fracture who were treated with a Gamma nail in our hospital from 2006 to 2010 were retrospectiverly evaluated.Results： Of the 249 patients,21（8.4%） failed with cutout of the lag screw.The mean tip-apex distance（TAD） of the patients with screw cutout was 35mm,compared with that of the patients who didn＇t have a cutout,and TAD measurement was reliable.The fracture reduction was also risk factor related to device cutout.Center and inferior position of the lag screw was protective against cutout. Conclusion： To decrease the risk of cutout,a good reduction is needed and the lag screw should be placed in the center or inferior part of the femur neck.The TAD is reliable predictor for cutout in intertrochanteric fracture.
出处
《东南大学学报（医学版）》
CAS
2013年第3期324-326,共3页
Journal of Southeast University(Medical Science Edition)
关键词
股骨转子间骨折
伽马钉
内固定失败
尖顶距
intertrochateric fracture
Gamma nail
failure of internal fixation
tip-apex distance
