粗隆间骨折前后移位与Gamma钉术中术后处理

The Fore and Back Displacement in Femoral Interchanteric Fracture and Treat ment in and post Operation with Gamma Nail

目的 :探讨粗隆间骨折前后移位对Gamma钉内固定术的影响及术后处理。方法 :对 6 3例患者术中及术后照片进行量度 ,统计前后移位超过 0 .5cm的病例及拉力螺钉偏离股骨头中线 1.0cm的病例。结果 :术后存在骨折前后移位者约 30 % ,以不稳定型骨折多见 ,拉力螺钉偏离股骨头中线者 10例 ,其中 3例发生拉力螺钉穿出股骨头。结论 :粗隆间骨折前后移位以不稳定型多见 ,部分移位发生与Gamma钉的安放有关 ,移位可导致拉力螺钉偏离股骨头中心 ,术中应适当使用放射线透视 ,对拉力螺钉偏离股骨头中心者术后应延迟下床负重活动。

Objective:To evaluate the fore and back displacement in femoral interchanteric fracture and its effect at treatment with Gamma nail. Methods: Sixty three patients with femoral interchanteric fracture were treated by Gamma nail, we measured the image in operation and photo after operation, total the patients with fore and back displaced above 0.5cm and the patients with compress screw displaced away the midline of femoral head above 1.0cm. Results: About 30% patients had fore and back displacement, more in the unstabile than others. Ten patients had compress screw displacement away the midline of femoral head, penetration of compression screws though the femoral head in three patients. Conclusion: The fore and back displacement are more in the unstabile fracture, some cases are concerned with the placement of Gamma nail, this could lead to the compress screw displace away the midline of femoral head, in the operation X ray set is needed, the patients should delay the time coming down for exerise.