不稳定型粗隆间骨折的治疗

The Treatment of Unstable Femoral Intertrochanteric Fracture

目的:报告应用DHS组合式TSP钢板治疗不稳定型粗隆间骨折的临床效果。方法:应用DHS组合式TSP钢板治疗26例伴大粗隆破坏的不稳定型股骨粗隆间骨折,观察术后嵌插和肢体短缩的程度,采用Merle DAubigne髋关节功能评分进行功能评价。结果:所有病人大粗隆的侧方移位均被有效的避免,在50％的病人中发现了限制性骨折嵌插,嵌插均小于14 mm,平均7．5mm,肢体短缩小于5．5mm。功能评价结果:优14例(53．84％),良9例(34．61％),差3例 (11．53％),优良率88．46％。结论:DHS系列支持钢板是治疗累及大粗隆的不稳定型股骨粗隆间骨折的有效方法,可以有效防止大粗隆的侧方移位及骨折端的过度嵌插。

Objective： To report the clinical effect of the implantation of the TSP in addition to the regular DHS on the trestment of unstable femoral intertrochanteric fracture.Methods： We have used DHS/TSP to treat 26 patients with femond/ntertrochanteric frac- ture combined with the greater trochanter fracture. The insertion of fracture end after operation and the limb shortness were observed. The hip function was evaluated aceording to Aubigne criteria. Results： The lateral dislocation of the greater trochanter frasment were effectively avoided in all patients. Slight insertion occurred in 50 percent of the patients and the insertion depth of fracture end were less than 14mm（average 7.5mm） , the llmb shortness were less than 5.5mm. According to the criteria of Aubigne, the hip function was 14 excellent（53.84%）, 9good（34.61%）, and 3 bad（11.53%）. The rate of excellent and good was 88.46%.Conclusion： In femoral intertrochanteric fractures with the greater trochanter fracture, the addition of TSP to the DHS was an effective treatment. It can effectively prevent the lsteral dislocation of the greater trochanter fragment and the excessive fracture impaction in these patients.