股骨转子间骨折髓外金属植入物固定系统的研究进展

A review of different extramedullary fixation devices in intertrochanteric fractures

背景:动力髋螺钉一直被认为是治疗股骨转子间骨折的"金标准",但随着微创理念和髓外内固定技术的发展,应充分了解各种内置物的特点。目的:评价不同髓外内固定系统对股骨转子间骨折临床效果、并发症及生物力学的影响。方法:由第一作者检索1990/2010PubMed数据及万方数据库有关不同髓外内固定系统在股骨转子间骨折临床效果、并发症及生物力学方面的文献。结果与结论:具有两枚或三枚头颈螺钉的经皮加压钢板及股骨近端锁定钢板内固定技术,能更有效降低股骨头的切出率,提高抗旋转性,增加骨折断端的稳定性,避免髋内翻塌陷畸形;引入了微创理念,具有钉、板分体的经皮加压钢板和股骨近端锁定钢板内固定系统在手术操上更加方便,对骨折处软组织干扰小,出血少,且减少了手术时间。

BACKGROUND：With the aging of the population,the incidence of intertrochanteric fracture increases apparently. Such fracture is currently treated with surgery,and the dynamic hip screw（DHS） has always been considered as ＂gold standard＂,but with the development of minimally invasive technique and extramedullary fixation technology,we should be fully aware of the characteristics of extramedullary fixation device,and strictly mastering the indications in order to reduce the surgical complications. OBJECTIVE：To discuss and compare traits,operative efficacy,complications and biomechanics of the extramedullary fixation devices in intertrochanteric fracture. METHODS：The first author retrieved PubMed and Wanfang databases for articles concerning operative efficacy,complications and biomechanics of the extramedullary fixation devices in intertrochanteric fracture published 1990/2010. RESULTS AND CONCLUSION：In treatment of intertrochanteric fracture,percutaneous compression plate and LCP with two or three femoral neck screw nails can reduce the incidence of complications,prevent hip varus,provide reliable fixation;minimally invasive technique can reduce operative time and the amount of exposure.