临床骨科杂志Issue(2)：181-183,3.DOI:10.3969/j.issn.1008-0287.2015.02.017
股骨转子间骨折人工关节置换术中转子部骨折固定技术的应用
Surgical techniques for the fixation of trochanteric fracture compartments in hip arthroplasty for femoral intertrochanteric fractures
摘要
Abstract
Objective To explore the ideal fixation techniques and selection criteria for trochanteric fracture frag-ments when treating intertrochanteric fractures of the femur by hip arthroplasty. Methods 86 cases of femoral inter-trochanteric fractures were undergone hip arthroplasties. According to Evans-Jenson classification,there were 2 cases with type Ⅱ fractures,22 with type Ⅲ,45 with type Ⅳ and 17 with type Ⅴ. 50 cases were received bipolar hemi-ar-throplasty and 36 cases were received total hip arthroplasty. Double cross binding fixation techniques with metal wires or cables were employed in 46 cases,cable-ready greater trochanteric reattachment fixation techniques in 28 cases,and other methods in 12 cases in treating femoral trochanteric fracture fragments. Results 78 cases got succeed in their operations with fracture displacement postoperatively in 5 cases (combined with loosening and sinking of femoral stem in 2 cases),dislocation in 1 case, deep periprosthetic infection in 1 case and dying of toxic ileus in 1 case. 2 cases got hypostatic pneumonia during hospitalization. No sciatic nerve injury and severe thromboembolic complications were found. 76 cases were followed up from 3 to 79 months except 2 cases lost after discharge,1 case died of acute myocardial infarction one year after operation and 1 case died of a brain hemorrhage in five months after operation. According to the Harris score of hip joint,the result at final follow-up was excellent in 52 patients,good in 13 and fair in 9, with excellent-good rate of 87. 8% . Inter trochanteric fracture healing time was 3 to 8 months. Conclusions Reliable fixation of trochanteric fracture fragments in hip arthroplasty treated for the femoral intertrochanteric fractures in the eldly has an important influence on deciding the time to start postoperative rehabilitation,walking gait and dura-bility of prostheses.关键词
股骨转子间骨折/关节成形术,置换,髋/内固定器Key words
femoral intertrochanteric fractures/arthroplasty,rleplacement,hip/internal fixators分类
医药卫生引用本文复制引用
储小兵,刘富存,童培建..股骨转子间骨折人工关节置换术中转子部骨折固定技术的应用[J].临床骨科杂志,2015,(2):181-183,3.基金项目
浙江省中西医结合骨关节病研究科技创新团队项目(编号:2011R50022) （编号:2011R50022）
