股骨远端锁定钢板治疗股骨粗隆周围骨折的临床研究

目的 探讨对侧股骨远端锁定钢板治疗股骨粗隆周围骨折的方法和效果.方法 自2004年6月～2008年1月,选用对侧股骨远端锁定钢板翻转应用于股骨粗隆周围骨折144例.其中,股骨粗隆间骨折104例,按AO分型:A1型24例,A2型48例,A3型32例;股骨粗隆下骨折加例,按Seinsheimer分类法:Ⅱ型10例,Ⅲ型14例,Ⅳ型8例,V型8例.结果 随访5～20个月,平均14个月.伤口一期愈合140例,浅表感染4例,经换药于术后2～6周均愈合.平均切口长度6.42 cm,平均手术时间57.34min,平均出血量212.39 ml.骨折平均愈合期:股骨粗隆间骨折为8～12周,粗隆下骨折为12～16周,骨折愈合率100%;无钢板松动、断裂及骨折再移位.功能评定:按髋关节功能评分(Harris评分),平均96分.结论 锁定钢板的钉-板角度稳定性强,有效减少了传统髓外内固定把持力不足、松动以致内固定失败等并发症的发生;对侧股骨远端锁定钢板翻转应用后可用的锁定螺钉可达5～7枚以上,且可穿出股骨距皮质经股骨粗隆部最坚强的股骨距部固定,操作更简单,固定更牢固,手术时间缩短,出血少;对股骨头的血运无明显破坏,同时无需显露更多的软组织,能有效保护骨折端的血运,更符合微创内固定原则,是治疗股骨粗隆周围骨折较理想的髓外内固定方法.

Clinical Study of Locking Compression Plate (LCP) of Fixation for Treatment of Femoral Peritrochanteric Fractures

Objective To investigate the value and clinical effects of opposite distal femoral locking compression plate (LCP) fixation for the treatment of femoral peritrochanteric fractures.Methods One hundred and forty-four cases of femoral peritrochanteric fractures that were treated with opposite distal femoral locking compression plate (LCP) fixation from June in 2004 to Janurary in 2008 were studied retrospectively.Among them,104 cases were intertrochanteric fractures,and 40 were subtrochanteric fractures.Result...