A2、A3型股骨粗隆间骨折DHS、DCS内固定的评价

The Evaluation of the A2 and A3 Styles of Intertrochanteric Fracture With the Use of DHS and DCS

目的研究股骨粗隆间骨折应用动力髋螺钉(DHS)和动力髁螺钉(DCS)两种内固定物对不同类型骨折的固定效果,探讨其最佳适应范围,以提高疗效,减少并发症的发生。方法118例患者119侧股骨粗隆间骨折按AO分型,对采用DHS、DCS内固定患者的临床资料及疗效进行分析总结。结果A2型48侧,DHS固定28侧,DCS固定20侧,其中DHS固定者6侧发生主钉切出和髋内翻,4侧内固定松动;A3型36侧,DHS固定16侧,DCS固定20侧,其中DHS固定者4侧发生主钉切出和髋内翻,4侧内固定松动;DCS固定者均预后良好,未出现并发症。结论A2型、A3型以DCS固定者疗效较好,DHS固定易出现并发症,影响疗效,应慎重选择。

Objective To study on the effect of the applications of DHS and DCS in intertrochanteric fracture and find the best usage for improving the effect and reducing complications. Method 119 sides of 118 cases intertrochanteric fracture from 2004 to 2009 were classified by AO classification and treated with DHS, DCS respectively. The clinical data and the result were analyzed and summarized. Result In 48 sides of A2, 28 sides were treated with DHS and 20 sides were treated with DCS, 6 sides appeared main nail coming out and coxa varus and 4 sides appeared inside fixation becoming flexible in DHS; in 36 sides of A3, 16 sides were treated with DHS and 20 sides were treated with DCS, 4 sides appeared main nail coming out and coxa varus and 4 sides appeard inside fixation becoming flexible in DHS, all the sides treated with DCS received good prognosis and did not have complications. Conclusion DCS is better to A2, A3. DHS is easy to appear complications, which should be chosen carefully.