动力髋螺钉(DHS)治疗股骨粗隆间骨折

Factors relating to the effect and rehabilitation of intertrochanteric fractures fixed with dynamic hip screws

目的:探讨影响动力髋螺钉治疗股骨粗隆间骨折疗效的相关因素,总结治疗经验。方法:采用自1998年8月～2009年8月以DHS治疗股骨粗隆间骨折108例患者。根据Merle D’Aubigne和Salvati-Wilson两种髋关节功能评分法评定患者术后髋关节功能恢复情况,记录患者下地负重行走的时间。结果:随访时间3～18个月。骨折均愈合,愈合时间2～4(2.6±0.6)个月。下地负重行走时间l～4(2.6±0.9)个月。1例出现髋内翻,未出现骨折处感染、继发骨折、螺钉穿出股骨头和钢板断裂病例。按Merle D’Aubigne髋关节功能评分:优16例,良86例,中6例,优良率94.4%;按Salvati-Wilson髋关节功能评分:优15例,良88例,中5例,优良率95.4%。结论:内固定安置正确,注意对股骨小转子复位和内侧结构的重建,适当延迟下地时间,可以取得良好的效果。

Objective:To study the factors related to the effect and rehabilations of intertrochanteric frectures treated with dynamic hip screws.Methods:108 with unilateral femoral intertrochanteric frectures fixed with DHS was collected.The follow-up was carried out to evaluate the function regaining according to the Merle D′Aubigne and Salvati-Wilson hip scores,the weight-bearing ambulation time was requested.Results:All the patients were followed up for3-18 months.All the fractures were union(2-4 months,mean 2.6±0.6months)without infection.stress fracture,nail penetration or plate breakage but 1 had coxa vara.The weight-bearing ambulation time Was l-4 months,mean 2.6±0.9 months.According to the Merle D’Aubigne hip score:16 were excellent,86 good,and 6 fair,and the excellent and good rate Was 94.4%.According to the Salvati-Wilson hip 8core:15 were excellent,88good,5 fair,and the excellent and good rate was 95.4%.Conclusion:With proper internal fixa-tion.attention to the apposition of the lesser trochanter and postponing the weight-bearing ambulation time properly,the result of intertrochanteric fracture treated with DHS will be satisfied.