股骨粗隆间骨折内固定手术后并发症原因分析

目的：探讨动力髋螺钉(DHS)和股骨近端髓内固定(Gamma钉、PFN)治疗股骨粗隆间骨折产生手术后并发症的原因。方法：总结2000～2004年用DHS和髓内固定系统治疗的共94例股骨粗隆间骨折病例，对6例出现手术后并发症病例的原因进行了分析。结果：94例患者中6例出现术后并发症，并发症种类包括6类：术后股骨干骨折；内固定物股骨头颈内切割；髋内翻；股骨头坏死；头颈螺钉穿人髋关节；骨折不愈合。结论：内固定物选择不当是发生手术并发症的重要原因，而不稳定骨折、严重骨质疏松、骨折复位不良、头颈螺钉位置不良都将增加手术并发症的发生率。

Reasons for the postoperative complications after the treatment of femoral intertrochanteric fracture with internal fixation

Objective:To analyse the reasons for postoperative complications after intertrochanteric fracture treatment with dynamic hip screw(DHS) and intramedullary nail. Method: From 2000 to 2004, 94 cases of intertrochanteric fracture were treated with dynamic hip screw or intramedullary nail. Postoperative complications occurred in 6 patients. All the 6 cases were analysed to find out the reason.Result: The complications included femoral shaft fracture after operation, cutting-out of lag screw, hip varus, osteonecrosis of femoral head, femoral head perforation of screw and non-union of fracture.Conclusion: Unsuitable implant selection is an important factor responsible for complications.Unstable fracture, serious osteoporosis, unsatisfactory reduction, incorrect position of lag screw will increase the incidence of complications.