加压滑动鹅头钉治疗股骨粗隆间骨折操作不当所致并发症的探讨

An Explorotary of Complications Caused by Wrong Operation in the Tre-atment of Intertrochanteric Fracture Using Slide Screw Plate

本文对加压滑动鹅头钉治疗股骨粗隆间骨折操作不当所致的１６例并发症进行了探讨。分析了影响骨折复位不良的原因：（１）解剖因素，骨折端受内收肌，髂腰肌和臀肌的牵拉作用，使骨折断端发生错位；（２）加压滑动鹅头钉从骨折断端置入影响复位。探讨了发生髋内翻的原因；（１）螺纹钉过短，失去加压固定效果；（２）复位中外展角度不够，在髋内翻的位置进行固定；（３）术中骨孔过度扩大，螺钉发生移动；（４）术后过度髋内收或早期负重。文章强调指出股骨矩和小粗隆对于维持股骨头颈的稳定性具有极其重要的意义。因此，应注意对小粗隆骨折片进行复位固定，可增加术后的稳定性，防止髋关节功能障碍。

It has been discussced in the paper that complications caused by wrong operationIi the treatmenti of intertrochanteric fractare using slide screw plate on 16 cases.The reasons ofmal-reduction also be discussed.1.Anatomy factors the fracture end be remored by the tractionof adductors gluteu and iliopsoas.2.The slide screw plate were placed Iito the fracture endimpairing reduction.the reasons of inversion of hip were as follows:(1)The slide screw was toowhort to get rigid fixation.(2)The abduction angle was not enough,the fixation was on the wongposition,(3)The hole to fit the screw was too large so the screw removed.(4)Over adduction andearly bear the full weight after the operation.Calcar and miner trochanter are very important to the stability of the femoral head and neck.Wehave pay attention to fix the splinter from minor trochanter to prevant the disturbance of thehip joint.