动力加压髋螺钉治疗股骨转子间骨折

目的探讨动力加压髋螺钉（dynamic hip screw，DHS）内固定治疗股骨转子间骨折的疗效。方法选择髋关节外侧切口，直视下复位，C形臂X线机监视下选择最佳髋螺钉进钉点后钻入导针，扩髓，攻丝，放置髋螺钉及钢板螺钉。本组42例，男26例，女16例；年龄38～84岁，平均54岁。结果42例随访时间1～5年，平均2．6年。复位及内固定满意率为85．7％（36／42），愈合率为97．6％（41／42），功能恢复至伤前水平为80．9％（34／42）。并发髋内翻为4．7％（2／42），其中1例为髋螺钉钉位不正，1例复位不良。骨不连2．3％（1／42），为髋螺钉钉位置不正，固定失败，螺钉折断后骨分离所致。结论正确掌握DHS内固定治疗股骨转子间骨折手术指征，规范手术操作及完善围手术期处理，是提高治疗效果的关键。

Internal Fixation With DHS in Treatment of Femoral Intertrochanteric Fracture

Objective To study therapeutic effect of internal fixation with dynamic hip screw（DHS） for treating femoral intertrochanteric fracture. Methods The hip lateral approach was made and reduction was performed. After properly selecting a location of inserted hip screw under fluorometry and drilling guide pins, reaming, tapping and placing the system of DHS were formed in succession. 26 of 42 patients in the study were male and 16 were female. The ages ranged from 38 to 84 years and averaged 54 years. Results Follow- up of 42 cases was taken （ 1 to 5 years ）. The satisfied rate of reduction and internal fixation was 85.7% （36/42）, bone healing was 97.6% （41/42）and recovery rate of functions on the whole was 80. 9% （34/ 42）. Surgical complications included coxa vara rate of 4. 7% （2/42） （ 1 patient resulted from inaccurate placement of screws and 1 was due to inadequate reduction）, bone nonunion rate of 2. 3% （1/42） （resulted from fracture displacement because of screws being broken）. Conclusion effects lies in taking operative indications in full consideration, standardizing The key to acquire satisfied manipulations and perfecting treatment of the perioperation.