复杂股骨粗隆间骨折的手术治疗

Operative treatment of the complex femoral intertrochanteric fracture

目的探讨治疗复杂性股骨粗隆间骨折的手术方法,以提高手术疗效。方法对我科自1995年～2004年收治48例复杂的股骨粗隆间骨折病人分别采用DHS(动力髋螺钉),DCS(动力髁螺钉)和Gamma钉治疗进行回顾性分析。结果本组病人手术后无切口感染及其它手术后并发症。术后随访10个月至18个月,手术后优良率达93.3%,仅3例发生髋骨翻。结论对于复杂的股骨粗隆间骨折,要视不同的情况采用不同的方法处理。DHS为股骨粗隆间骨折固定的常用方法,在使用中要强调股骨距,小转子的复位和固定。DCS适合于不稳定粗隆间骨折(A3型),Gamma适合于严重的粉碎性骨折(A2型)。

Objective To study the operative treatment of the complex femoral intertrochanteric fracture in order to improve the curative effect.Methods From 1995 to 2004,48 cases with complex femoral intertrochanteric fracture received the treatment of DHS, DCS and Gamma nail were analyzed retrospectively.Results No wound infection and other complications were found in all cases after operation. Postoperative follow-up time was 10 months to 18 months. The operative excellent rate was 93.3%.Coxa vara was happened in 3 cases.Conclusion DHS is a common use method for the treatment of fixation of the femoral intertrochanteric fracture.But,in the course of use,the reduction and fixation of lesser trochanter should be emphasized.The operation indications of the Gamma nail and DCS are suitable for the A2 type and A3 type of femoral intertrochanteric fracture respectively.