股骨近端锁定板治疗不稳定型股骨粗隆间骨折失败的原因分析

Failure analysis of unstable femoral intertrochanteric fracture by proximal femoral locking plate

股骨粗隆间骨折是指股骨基底部至小粗隆水平以上部位的骨折,属于关节囊外骨折,约占髋部骨折的50%,多发于老年人,女性多于男性,随着全球人口老龄化速度的加快,股骨粗隆间骨折的发生率成逐年升高的趋势。而在老年病患中,常伴有骨质疏松和内科疾病,保守治疗往往效果较差,并发症及死亡率较高。因此,目前国内外均主张早期手术治疗,以尽早功能练习,恢复患髋功能,减少畸形愈合的发生率,从而减少全身并发症的出现。在手术治疗方法中,采取股骨近端锁定板进行固定是比较常用的内固定方式,但随着股骨近端锁定板的广泛应用,也出现了一些失败的病例。本文对采用股骨近端锁定板治疗不稳定型股骨粗隆间骨折手术失败的原因做如下综述。

Femoral intertrochanteric fracture, a kind of extracapsular fracture, refers to fracture from the basement offemur to the part above tuberosity, accounting for about 50% of hip fractures. It generally happens among the elderly,with females outnumbering males.With the increasing pace of aging around the globe, the ccurance rate of femoral in-tertrochanteric fracture increases annually.Among elderly patients, it is often accompanied by osteoporosis and otherdiseases.The effect of conservative treatment is poor, with high incidence of complications and mortality.Therefore,early surgical treatment is advised both home and abroad to exercise and recover hip functions, lowering the occur-rence of malunion and systematic complications. In surgical treatment plans, proximal femoral locking plating fixationis an often adopted internal fixation method.There were also a few failure cases in the application of proximal femorallocking plate.The article reviewed the reasons for failures in the surgical treatment of unstable femoral intertrochantericfracture by proximal femoral locking plate.