难复位股骨粗隆间骨折的手术治疗

Surgical Treatment of Intertrochanteric Fractures with Failure in Close Reduction

目的 :探讨移位明显难复位的股骨粗隆间骨折的手术治疗方法。方法 :内固定术前不能达到满意复位的股骨粗隆间骨折 2 2例患者 ,采用Watson Jone手术入路 ,开放整复及动力髋螺钉 (DynamicHipScrew ,DHS)内固定术。结果 :2 2例股骨粗隆间骨折均达到满意复位 ,术后平均 1个月扶拐行走 ,平均随访 2年 2个月 ,骨折愈合 ,疗效评定优 15例、良 5例、中 2例。结论 :对移位明显 ,内固定前难复位的股骨粗隆间骨折应果断采用开放整复方法 ,解除软组织在骨折间的嵌入 ,达到骨折满意整复 ,这是保证骨折愈合、功能恢复的重要手段。

Objective:To explore a surgical technique for intertrochanteric fractures with displacement and farlure in close reduction. Methods: 22 intertrochanteric fractures with failure in close reduction were treated by an open reduction and internal fixation with a dynamic hip screw. Results: All 22 cases were reduced in optimum position. All patients could walk with crutches 1 month after operation in average. An average 2 years and 2 months follow up showed that intertrochanteric fractures healed up completely. Effect evaluation showed excellent in 15 patients,good in 5 ,and moderate in 2. Conclusion: For intertrochanteric fractures with failure in close reduction,an open reduction should be performed immediately to remove the soft tissues between the ends of fractures and to achieve an optimmum reduction,which is very important for fracture healing and function recovering.