微创定点定向法在DCS(DHS)中的研究和应用

Study and Application of Micro-wound Locating-point and Locating-Direction Method in Dynamic Condyle(hip) Screw(DCS/DHS)

目的 研究动力髁(髋)螺钉钢板[DCS(DHS) ]在治疗股骨远端、股骨粗隆间、粗隆下骨折中的微创定点定向方法。方法 对2 0 6例成人股骨远端或股骨粗隆间或粗隆下骨折行切开复位,DCS或DHS内固定术。结合局部解剖的形态学分析和X线表现,归纳拉力螺纹钉的定位方法。结果 术后随访9～36月,平均18月,总有效率93.7% ;术中定位导针的放置方法归纳为:“3.2 .1”定点法和“3线”定向法。结论 DCS(DHS)内固定术是治疗股骨远端、粗隆间、股骨粗隆下骨折的有效方法;熟悉股骨远端、股骨粗隆间、粗隆下的解剖形态比单纯在X线照射下放置定位导针更有积极意义;结合术前的X线片测量和术中实际情况,微创定点定向法有利于增加手术的精确度,缩短手术时间。

Objective To study the micro-wound locating-point and locating-direction method in dynamic condyle(hip) screw on distal femoral fracture or femoral inter-trochanteric or sub-trochanteric fracture. Methods Two hundred and six adult patients with distal femoral fracture or femoral inter-trochanteric or internal-fixation under went open reduction. The orientation methods of screw were summaried combining with morphologic analysis of the local anatomy and foentgenogram. Results After the follow-up of 9 to 36 months(average 18 months), the total effective rate was 93.7%, the method of installing guide-pin was summarized as '3.2.1' locating-point method and '3 lines' locating-direction method. Conclusion DCS(DHS) internal-fixation is an effective method for treatment of distal femoral fracture or femoral inter-trochanteric or sub-trochanteric fracture. Knowing the anatomical figure of distal femur and trochanter is more significant than installing guide-pin with the X-ray shine alone;combined with of foentgenogram and actual circumstance in opration, it is advantageous that the accuracy of surgical operation was increased,surgical operation time reduced for micro-wound locating-point and locating-direction method.