髓内固定联合张力带钢丝固定治疗股骨粗隆间不稳定性骨折的临床疗效评价

目的探讨髓内固定联合张力带钢丝固定治疗股骨粗隆间不稳定性骨折的临床疗效。方法回顾性分析2010年5月--2012年8月在本院接受髓内固定联合张力带钢丝固定治疗的79例股骨粗隆间不稳定性骨折患者的临床资料，评价患者骨折愈合时间和恢复优良率。结果所有患者骨折愈合时间平均为（13．5±2．3）周，手术优良率为96．2％。术后有3例出现严重髋痛，下肢外旋、内翻缩短且超过2cm，以及Trendelenburg征阳性，其中1例发生张力带钢丝断裂，重新手术。结论髓内固定联合张力带钢丝固定的治疗方案能很好地复位小转子和大粗隆，有效减少患者术后髋关节的疼痛和下肢短缩，是治疗股骨粗隆间不稳定性骨折的有效疗法。

Clinical efficacy analysis of intramedullary fixation with tension band wire fixation in the treatment of unstable intertrochanteric fracture

Objective To investigate the clinical efficacy of intramedullary fixation with tension band wire fixation in the treatment of unstable intertrochanteric fracture. Methods From May 2010 to August 2012, we followed up 79 unstable intertrochanteric fracture patients who re- ceived the intrarnedullary fixation with tension band wire fixation treatment. Clinical data were re- viewed, and patients＇ healing time and excellent recovery rate were observed. Results The frac- ture healing time was （ 13.5 ＋ 2.3） weeks, and the excellent and good rate was 96.2%. Postopera- tively, 3 patients had severe hip pain, lower limb external rotation, varus shorter and more than 2 cm, and Trendelenburg sign positive, and 1 case had tension band wire fracture. Conclusion In- tramedullary fixation with tension band wire fixation method can reset the lesser trochanter and the greater trochanter, and it is very effective in reducing postoperative hip pain and lower limb shorten- ing for the instability of intertrochanteric fracture.