可附接外侧支撑板对动力髋螺钉治疗股骨转子间骨折固定稳定性的影响
The effect of an attachable lateral support plate on the stability of intertrochanteric fracture fixation with a sliding hip screw.
作者信息
Su Edward T, DeWal Hargovind, Kummer Frederick J, Koval Kenneth J
机构信息
Department of Orthopaedic Surgery, Hospital for Joint Diseases Orthopaedic Institute, New York, New York 10003, USA.
出版信息
J Trauma. 2003 Sep;55(3):504-8. doi: 10.1097/01.TA.0000052361.46518.3B.
BACKGROUND
Use of a sliding hip screw (SHS) alone for some unstable intertrochanteric femur fractures can allow excessive medial shaft displacement during impaction. This study evaluated the effect of an attachable lateral support plate on these fractures after loading.
METHODS
Unstable, three-part intertrochanteric fractures were created in 10 matched pairs of embalmed femurs that were instrumented with 135-degree SHSs with or without an attachable lateral support plate. Under physiologic loading, inferior and lateral head displacements and lag screw sliding distances were measured.
RESULTS
After 10,000 cycles at 750 N, all measurements for femurs with the lateral support plate were significantly less than for the femurs with the SHS alone: mean lateral difference was 1.7 mm (34%) (p < 0.05), mean inferior difference was 3.0 mm (38%) (p < 0.05), and mean lag screw sliding difference was 4.5 mm (58%) (p < 0.05).
CONCLUSION
The addition of an attachable lateral support plate to an SHS significantly decreased displacement of the femoral head after cyclic loading.
背景
对于一些不稳定型股骨转子间骨折，单独使用滑动髋螺钉（SHS）在加压过程中可能会导致股骨干过度向内侧移位。本研究评估了可附加外侧支撑板对这些骨折在加载后产生的影响。
方法
在10对防腐处理的股骨上制造不稳定的三部分股骨转子间骨折，这些股骨安装有135度的SHS，有的带有可附加外侧支撑板，有的没有。在生理负荷下，测量股骨头的下向和外侧移位以及拉力螺钉的滑动距离。
结果
在750N的负荷下经过10000次循环后，带有外侧支撑板的股骨的所有测量值均显著小于单独使用SHS的股骨：平均外侧差异为1.7mm（34%）（p<0.05），平均下向差异为3.0mm（38%）（p<0.05），平均拉力螺钉滑动差异为4.5mm（58%）（p<0.05）。
结论
在SHS上附加可外侧支撑板可显著减少循环加载后股骨头的移位。
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