动力髁螺钉治疗不稳定型股骨粗隆间骨折

Treatment of unstable intertrochanteric fracture with dynamic condylar screw

[目的]探讨动力髁螺钉（DCS）治疗不稳定型股骨粗隆间骨折的临床疗效。[方法]总结本院2000年9月～2004年9月间使用动力髁螺钉（DCS）进行内固定治疗的不稳定型股骨粗隆间骨折患者的病例资料，评价其疗效。骨折采用Evang分型，其中将Evan＇sⅢ型、Evan＇sⅣ型以及反粗隆间Evan＇sⅤ型骨折列为不稳定型骨折。[结果]术后平均随访10个月（8～15个月），骨折全部愈合；平均愈合时间4个月，无髋内翻及内固定衰竭发生，髋关节优良率89％。[结论]对于大粗隆下方存在骨折的Evan＇sⅢ型，Evan＇sⅣ型及反粗隆间Evan＇sⅤ型等不稳定型股骨粗隆间骨折的患者使用动力髁螺钉（DCS）进行内固定治疗，可以有效降低内固定物衰竭及髋内翻的发生率，临床效果满意。

[Objective ] To evaluate the effect of treatment of unstable intertrochanteric fracture with dynamic condylar screw. [ Method] Fifty-six cases of unstable intertrochanteric fractures were treated with typical ORIF （open reduction and internal fixation） with dynamic condylar screw from 2000 to 2004. According to the Evan＇s classification systems, there were 19 cases of Evan＇sⅢ fracture, 27 cases of Evan＇sⅣ fracture and 10 cases oblique reverse Evan＇sⅤ fracture. The average period of follow-up was 10 months （8 - 15 months）. [ Result] All cases had union with average union time of 4 months, no coxae inversion, fixation failure and fracture nonunion. The satisfactory rate of function was 89%. [ Conclusion ] For unstable intertrochanteric fracture, including Evan＇sⅢ , Evan＇sⅣ and oblique reverse Evan＇sⅤ fracture, using DCS is a good method to improve the clinical results.