联动复位法治疗难复性股骨转子间骨折

Treatment of irreducible femoral intertrochanteric fracture with the combined reduction method

目的探讨联动复位法治疗难复性股骨转子间骨折的临床疗效。方法应用联动复位法治疗20例难复性股骨转子间骨折患者,即在股骨头颈处闭合打入1～2枚3. 0 mm斯氏针,转动斯氏针复位旋转的股骨转子部近端,使骨折复位达到满意,再用股骨近端防旋髓内钉(PFNA)固定骨折。观察患者髋内翻、股骨头颈切割、断钉及退钉等情况,采用髋关节Harris功能评分评价疗效。结果患者均获得随访,时间6～24个月。患者骨折均愈合良好,无髋内翻、股骨头颈切割、断钉及退钉情况发生。末次随访根据髋关节Harris功能评分评价疗效:优14例,良4例,可2例。结论术中加用斯氏针能使难复性股骨转子间骨折得到有效快速的复位,具有操作简捷、疗效确切的优点。

Objective To investigate the clinical effect of combined reduction method in the treatment of irreducible femoral intertrochanteric fracture. Methods Twenty patients with irreducible femoral intertrochanteric fracture were treated with combined reduction method. That was one or two 3.0 mm Steinmann pins were inserted into the femoral head and neck, the fracture reduction of the proximal end of the rotating femoral trochanter was satisfactory by rotating the pins, and the fracture was fixed with the proximal femoral nail anti-rotation (PFNA). The effect was analyzed by observing the patients′ hip turnover, femoral head and neck incision, broken nails and removed nails, the Harris hip function score was used to evaluate the curative effect. Results All patients were followed up for 6~24 months after surgery. All fractures healed well without hip turnover, femoral head and neck incision, broken nails and removed nails. At the last follow-up, the score of post-traumatic Harris hip function were excellent in 14 cases, good in 4, fail in 2. Conclusions Intraoperative addition of the Steinmann pin is effective and quick reset for treating irreducible femoral intertrochanteric fracture with simple operation, and effective curative effect.