股骨粗隆部反转子间骨折的手术治疗策略

目的探讨股骨粗隆部反转子间骨折的手术治疗策略。方法通过对Gamma钉和锁定加压接骨板治疗61例股骨粗隆部反转子间骨折的回顾和总结。结果 54例一期骨性愈合,平均4.5个月;Gamma钉组5例进行翻修,优良率89.58%;锁定加压接骨板组2例骨折延迟愈合,优良率92.31%。结论良好的闭合复位或小切口辅助复位固定是基础;根据骨折的分型和骨质情况,选用适合的内固定方法是提高疗效,防止并发症发生的关键;Gamma钉更适用于A3Ⅲ型骨折,锁定加压接骨板适用于A3Ⅰ型和A3Ⅱ型骨质疏松骨折。

Treatment ofreverse obliquity intertrochanteric fracture of femur

Objective To analysis of treatment of reverse obliquity intertrochanteric fracture of femur.Methods Systematic review 61 cases of reverse obliquity intertrochanteric fracture of femur in patients treated with Gamma nails or the locking compression plates(LCPs).Results One-stage bone healing was achieved in 54 cases for mean 4.5 months,5 cases suffered from revisions in gamma nails group with excellent and good rate of 89.58%.2 cases suffered from revisions in LCPs group with excellent and good rate of 92.31%.Conclusion The factors of avoiding complications include good reduction,small incision and correct selection of internal fixations,Gamma nail was suitable for A3Ⅲ fracture.LCP was suitable for A3Ⅰ fracture and A3Ⅱfracture.with the locking compression plate(LCP).