力臂式外固定器治疗股骨粗隆间骨折实验研究和临床应用

目的观察改进的穿针方法力臂式固定器治疗股骨粗隆间骨折的生物力学效应和临床疗效。方法（１）１２个人工股骨模型按不同骨折类型分为４组，分别采用交叉、桁架、交手架、平行穿针法外固定，对其进行力学测试，数据用统计学处理。（２）１９８６年２月～１９９６年５月治疗病人１５９例，平均固定１０周。结果（１）１２个模型在纵向载荷时断端较稳定；桁架穿针固定在纵向、侧向刚度都有所增强（Ｐ＜００５）；交手架穿针固定反粗隆间骨折在侧向载荷时不稳定（Ｐ＜０００１）。（２）１５９例病人除９例死于内科疾病外，全部骨折愈合。结论改进的穿针法力臂式外固定器治疗股骨粗隆间骨折承载效果满意，操作简单，创伤小，并扩大了手术适应症

Treatment of Intertrochanteric Fracture of Femur with External Fixator in Lever Type Experimental Research and Clinal Application

Objective To observe the biomechanical effectiveness and clinical therapeutic effect of the improved pinning method and external fixator in lever type on the treatment of intertrochanteric fracture of the femur.Methods (1)Three types of intertrochanteric fractures,made on 12 artificial models of femur(Sawbome),were divided into 4 groups based upon the type of fracture and fixed with cross pins,truss pins,scaffold pins and parallel pins,respectively.And then the biomechanical parameters of them were measured and the obtained data were treated stastically.(2)Intertrochanteric fractures in 159 patients were fixed,based upon their type,with the improved pinning method and external fixator for 10 weeks in average. Results (1)The fractures of 12 models were fixed more stably during longitudinal loading;the rigidity of the fracture models fixed with the truss pins was increased during both longitudinal and lateral loading( P <0 05);the fixation of abduction intertrochanteric fractures with the scaffold pins was unstable during lateral loading( P <0 001).(2)With the exception of 9 cases died of internal diseases,the fractures in 150 patients were all bony union. Conclusion There was satisfactory effectiveness,such as satisfactory load bearing,simple operation,less damage and enwidened operative indications,in the treatment of intertrochanteric fractures with the improved pinning method and the external fixator in lever type.