股骨粗隆间骨折术后并发症及原因分析

目的回顾性分析股骨粗隆间骨折的术后并发症并分析其原因。方法 2008年1月~2012年12月,我院手术治疗股骨粗隆间骨折共295例,按Evans分型,Ia型26例,Ib型53例,Ic型97例,Id型52例,II型67例。其中DHS组59例,IMHS组80例,PFN组25例,GAMMA3组28例,INTERTAN组103例。随访3~36个月,对部分发生并发症的病例进行手术干预。结果内固定物切割6例,拉力螺钉退出2例,髋内翻、下肢短缩12例,感染6例,血管损伤2例,股骨头无菌性坏死2例,内植物远端骨折2例,部分经再次手术治疗治愈。结论手术治疗股骨粗隆间骨折,要结合骨折类型、患者全身情况合理选用内固定物,术中复位及操作技术的改进以及术后适度的功能锻炼,能够减少术中及术后并发症的发生。

Complications of postoperation of intertrochanteric fracture and analysis of causes

Abstract] Objective Retrospective analysis the complications of intertrochanteric fracture post-opratively. Methods 295 cases of intertrochateric fracture were operatived from January 2008 to December 2012, According to Evans classification, type Ia 26 cases,type Ib 53 cases,type Ic 97 cases,Id 52cases,II 67cases.Among them, 59 cases fixed with DHS,80cases fixed with Asian IMHS ,25cases fixed with PFN,28cases fixed with GAMMA3and 103 cases fixed with INTERTAN. Some complications were intervened with re-operation.Results Cut-out in 6 cases, quit of the lag screw in 2 cases,coxa vara and shortening of the lower limb in 12 cases,infection in 6 cases, blood vessel injury in 2 cases, necrosis of femoral head in 2 cases and periprosthetic fracture in 2 cases,Some of them had to receive re-operation and healing. Conclusion In treating intertrochateric fracture operatively,the internal fixation should be selected considering with fracture type and general condition, complications should be reduced with improving of reduction and surgical technique and moderate dirigation post-operative.