Celebi L, Can M, Muratli H H, Yagmurlu M F, Yuksel H Y, Bicimoğlu A
Ankara Numune Education and Research Hospital, 3rd Department of Orthopaedics and Traumatology, Ankara, Turkey.
Injury. 2006 Aug;37(8):740-50. doi: 10.1016/j.injury.2005.12.022. Epub 2006 Feb 17.
Surgical treatment of comminuted subtrochanteric fractures may be associated with high incidences of non-union and implant failure. Biological fixation may solve this problem by encouraging rapid callus formation which buttresses the medial cortex.
In all, 33 patients with comminuted subtrochanteric femur fractures underwent indirect reduction and biological internal fixation. The mean age of the group was 39.12 (19-64) years.
Patients were followed up for a mean of 24.6 (12-66) months. Union was achieved within a mean of 15.10 (13-22) weeks, with no cases of delayed union or non-union but with limb-length discrepancy, mean 1.22 (1-2) cm, in nine cases. According to the Traumatic Hip Rating Scale, functional results were excellent in 23 and good in 10 cases.
Indirect reduction and biological internal fixation yield acceptable results in comminuted fractures. These good results can be attributed to early weight-bearing with rapid solid callus formation and early union, which are particularly advantageous in comminuted subtrochanteric fractures, avoiding the implant failure which is not uncommon in these fractures.
股骨转子下粉碎性骨折的手术治疗可能伴有不愈合和植入物失败的高发生率。生物固定可通过促进快速骨痂形成来支撑内侧皮质，从而解决这一问题。
共有33例股骨转子下粉碎性骨折患者接受了间接复位和生物内固定。该组患者的平均年龄为39.12（19 - 64）岁。
患者平均随访24.6（12 - 66）个月。平均在15.10（13 - 22）周内实现骨折愈合，无延迟愈合或不愈合病例，但9例存在肢体长度差异，平均为1.22（1 - 2）cm。根据创伤性髋关节评分量表，23例功能结果为优，10例为良。
间接复位和生物内固定在粉碎性骨折中取得了可接受的结果。这些良好结果可归因于早期负重、快速形成坚实骨痂和早期愈合，这在股骨转子下粉碎性骨折中尤为有利，避免了这些骨折中并不罕见的植入物失败。
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