闭合复位经皮微创动力内固定架治疗股骨转子部骨折

目的 探讨微创动力内固定架治疗股骨转子部骨折的疗效. 方法 2005年1月至2007年1月在C形臂X线机透视下闭合复位,小切口微创手术入路,经皮微创动力内固定架治疗转子部骨折16例,其中男11例,女5例;年龄25～78岁,平均48.6岁.按股骨转子间骨折改良的Evan's分型:Ⅰ型1例,Ⅱ型2例,Ⅲ型4例,Ⅳ型3例,Ⅴ型2例;股骨转子下骨折4例. 结果 本组手术时间38～70 min,平均45 min;手术切口 3.5～4.5 cm,平均3.9 cm;术中出血量50～90 mL,平均68.6mL;临床愈合时间55～92 d,平均68.9 d;住院时间14～19 d,平均15.6 d;自由负重时间为术后36～78 d,平均43.6 d.所有患者获得6～36个月(平均14.7个月)随访.根据X线评价:16例骨折均达骨性愈合.按照董纪元疗效评价标准评定疗效:优14例,良1例,可1例,优良率93.8%. 结论 经皮微创动力内固定架治疗转子部骨折,手术简便快速、创伤少、固定牢、愈合快、术后并发症少,是对转子部骨折有效的内固定方法.

Clinical evaluation of cosed reduction and minimally invasive dynamo-internal fixation frame for femoral trochanteric fractures

Objective To evaluate the clinical effects of minimally invasive dynamo-internal fixation frame in treatment of trochanteric femoral fractures. Methods Sixteen cases of trochanteric femoral fractures were treated with closed reduction guided by C-arm fluoroscopy, minimally invasive incision ap-proach, and fixation by minimally invasive dynamo-internal fixation frame. They were 11 males and 5 females,with an average age of 48.6 years (25 to 78) . Results The mean length of incision was 3.9 cm, the mean blood loss 68.6 mL, the mean duration of operation 45 minutes and the mean duration of bone healing 68.9 days (55 to 92). The hospital stay averaged 15.6 days, and the time for free weight loading 43.6 days.X-ray manifestation showed that all patients obtained bone union. The excellent-to-good rate was 93.8%.Conclusions The percutaneous minimally invasive dynamo-internal fixation frame is a new effective device for femoral trochanterie fractures, because it can result in convenient operation, minimal invasion, stable fixation and few complications.