动力髋螺钉治疗股骨粗隆间骨折失效分析

目的通过回顾性分析2000年1月至2007年4月动力髋螺钉内固定治疗156例股骨粗隆间骨折病例，探讨31例动力髋螺钉内固定治疗股骨粗隆间骨折失效的原因。方法利用股骨粗隆间骨折Evans分型，从尖顶距值和骨质疏松等方面对内固定失效结果进行统计分析。结果Evans分型Ⅰ型无失效病例，Ⅴ型失效比例最大，为44．4％；尖顶距值在25mm以下时，无内固定失效病例，若尖顶距值大于45mm时，内固定失效比例达80．6％；在不稳定型骨折中，骨质疏松组内固定失效比例最大，为39．3％。结论动力髋螺钉内固定要选择合适的适应证；深刻理解熟练掌握动力髋螺钉应用技术；动力髋螺钉内固定失效同骨质疏松严重程度有关。

The Study of Failure of Intertrochanteric Fracture Treated by Dynamic Hip Screw

Objective To investigate failures of intertrochanteric fractures treated by dynamic hip screw （DHS） fixation. Methods 156 cases treated by DHS fixation were studied between January 2000 and April 2007. Evansr classification and TAD＇s vaule were used to evaluate the effect of the DHS fixation. Results 20 cases showed radiographic failures was 44.4 % in Evans Ⅴ failure group. DHS fixation failure rate was 80.6 % when TAD value was more than 45 ram. Unstable fractures with osreoporosis had a failure rate of 39.3 %. Conculsion To avoid the DHS fixtion failure .selecting the appropriate patients ,positioning the screw properly should be done. Osteoporosis is also related with the effect of the DHS fixation.