动力髋系统内固定治疗股骨粗隆下骨折

Internal Fixation of Dynamic Hip Screw for Femoral Subtrochanteric Fracture

目的探讨动力髋系统内固定治疗股骨粗隆下骨折的临床疗效。方法股骨粗隆下骨折28例，按Seinsheimer分类：Ⅱ型5例，Ⅲ型8例，Ⅳ型12例，V型3例，均采用动力髋系统内固定治疗，术后行功能锻炼。结果本组均获随访，平均15（6～24）个月。术后3～5个月复查X线片示骨折均愈合。按Harris关节功能评分标准：优23例，良3例，差2例，优良率为92．9％。结论采用动力髋系统内固定和规范的功能锻炼治疗股骨粗隆下骨折可获得满意疗效，有效降低髋内翻、患肢短缩、外旋畸形等并发症的发生率。

Objective To explore the clinical effect of open reduction and internal fixation with dynamic hip system （DHS） to treat femoral subtrochanteric fracture. Methods 28 cases with femoral subtrochanteric fracture were underwent open reduction and internal fixation with DHS. The Seinsheimer fracture classification was type Ⅱ in 5 cases, type Ⅲ in 8, type Ⅳ in 12 and type Ⅴ in 3. Postoperative functional exercise was performed. Results All cases were followed up for 6 to 24 months （ mean 15 ） and achieved bone union within 3 to 5 months. The joint function evaluation of Harris Score showed 23 of excellence, 3 of good, and 2 of false, and the fineness rate was 92.9%. Conclusion The management of DHS internal fixation plus normative functional exercise for femoral subtrochanteric fracture can attain satisfactory therapeutic outcome, and reduce the complications such as coxa adducta, crispation and extorsion deformity of the wounded affected extremity.