动力髋螺钉上方加抗旋转螺钉治疗股骨转子间骨折的生物力学特点:32例回访资料回顾

Biomechanical characteristics of dynamic hip screws and anti-rotational screws for intertrochanteric fractures:A data review of 32 cases follow-up

背景：单纯应用动力髋螺钉固定股骨转子间骨折其抗旋转能力及骨折稳定性均欠佳。目的：观察动力髋螺钉结合抗旋转螺钉治疗股骨转子间骨折的生物力学特点。方法：采用在动力髋螺钉上方加1枚抗旋转螺钉治疗股骨转子间骨折38例患者。对其中32例接受切开复位动力髋螺钉结合抗旋转螺钉置入固定且病历随访资料完整的股骨转子间骨折患者进行回顾性分析。结果与结论：32例获随访3~18个月。骨折平均愈合时间18.1周,无内固定物松动、断裂及再骨折发生。按黄公怡疗效评定标准进行疗效评定,其中优21例,良8例,中3例,差0例,优良率90.6%。结果证实,动力髋结合抗旋转螺钉治疗股骨转子间骨折固定牢靠,抗旋转作用强。

BACKGROUND： Anti-rotation ability and fracture stability of using simple dynamic hip screws for femoral intertrochanteric fractures fixation is poor. OBJECTIVE： To observe the biomechanical characteristics of dynamic hip screws and anti-rotational screws for treatment of femoral intertrochanteric fractures. METHODS： Thirty-eight patients who used dynamic hip screws and anti-rotational screws for femoral intertrochanteric fracture were selected. Thirty-two patients who received reduction and fixation with dynamic hip screws and anti-rotational screws for femoral intertrochanteric fracture were retrospective analysed. RESULTS AND CONCLUSION： Totally 32 cases were followed up for average 12.6 months （ranged from 6 to18 months）. All the patients obtained bone union in average 18.1 weeks. There were no cases with implant loosening or refracture. According to Harris rating scale, the excellent and good rate was 90.6%, evaluation 21 cases in excellent, 8 cases in good, 3 cases in average and 0 case in poor. Internal fixation of dynamic hip screws and anti-rotational screws are suitable for femoral intertrochanteric fracture and this method have characteristics of large definitive rotational stability and rigid fixation.