闭合复位经皮超低角螺钉加压钉固定治疗股骨粗隆间骨折临床研究

A Clinical Study of Close Redaction and Fixation with Ultraslow Angular Compression Screw for Femur Intertrochanteric Fracture

目的 :研究一种新的股骨粗隆间骨折的固定系统 ,使之对此骨折固定更加简便、坚固、应用更广泛、提高治疗效果。方法 :自行设计一套超低角螺钉 -加压钉系统 ,在 2 4根尸体股骨干上段进行加载试验和重复载荷试验 ,然后用于 1 3 0例临床病人 ,评价其骨折愈合时间和并发症。结果 :生物力学测试表明 ,本固定系统对抗破坏载荷和耐疲劳性能优于 1 40°角钢板、麦氏鹅头钉、多枚斯氏针固定方法。临床结果表明 ,采用本系统固定的患者 ,骨折临床愈合时间短 ,可用于合并多种疾病的老年人 ,未发生手术并发症 ,术后功能优良率达到87。 7%。结论 :超低角螺钉系统治疗股骨粗隆间骨折具有操作简单 ,损伤小 ,合并症少 ,较其它固定物更加牢固 ,更加符合股骨粗隆部的力学特征 ,且具有操作简单、损伤小 ,应用更广泛 ,更适合应用于老年人及有较多合并疾病的患者的优点。

Objective:To design a new fixation system for femur intertrochanteric fracture, which should be more simple, stronger, extensive usage in clinic and improve treatment results.Methods:A ultraslow angular compression screw was made and test on 24 cadaveric femur specimens, and then using for 130 cases. Time of bone union and complications were evaluated.Results:Biomechanical test howed that this fixation system is superior to 140 degree angular plate, Mclawghlin nail and multiple Steinmann's pin on anti-load property. Clinical result also showed that bone union time is shorter. It can be using for senile patients with different disease. There is no operation complications for all cases. The superior rate of hip function arrived 87.7%.Conclusion:There is some advantage for the ultraslow angular compression screw for femur intertrochanteric fracture, such as simple operation, less injure, less complications and can be used for older patients who with combined diseases.