Department of Orthopaedics, Physical Medicine, Paraplegia and Rehabilitation, Pt. B. D. Sharma Post Graduate Institute of Medical Sciences, 1/7J, Medical Enclave, Rohtak, 124001 Haryana, India.
Int Orthop. 2010 Feb;34(1):125-9. doi: 10.1007/s00264-009-0744-y. Epub 2009 Mar 14.
The sliding compression device, a widely used implant in unstable proximal femoral fractures, suffers from two major limitations: excessive collapse and screw cut-out. Commonly attributed reasons for these are lateral wall comminution and single-point fixation, respectively. We report our experience of stabilising 74 unstable trochanteric fractures, of which 46 cases underwent lateral wall reconstruction using a trochanteric stabilising plate (TSP) in combination with a dynamic hip screw (DHS), and 34 cases with an intact lateral wall had a DHS with an additional anti-rotation screw providing two-point fixation. Fracture consolidation was observed in all cases at an average of 13.56 weeks. Overall functional hip score as per the Salvati and Wilson scoring system was >30 points in 55 patients. Lateral wall reconstruction is an important component in stabilisation of unstable trochanteric fractures and a combination of TSP with a DHS appears to be a useful device to achieve this. Addition of an antirotation screw is likely to enhance the stability further by providing two-point fixation.
滑动加压固定装置是一种广泛应用于不稳定型股骨近端骨折的植入物，但存在两大局限性：过度塌陷和螺钉切出。通常认为其原因分别为外侧壁粉碎和单点固定。我们报告了使用外侧壁重建稳定 74 例不稳定型转子间骨折的经验，其中 46 例采用转子间稳定钢板（TSP）联合动力髋螺钉（DHS）进行外侧壁重建，34 例外侧壁完整的病例采用 DHS 加抗旋螺钉提供两点固定。所有病例平均在 13.56 周时观察到骨折愈合。根据 Salvati 和 Wilson 评分系统，55 例患者的总体髋关节功能评分>30 分。外侧壁重建是不稳定型转子间骨折稳定的重要组成部分，TSP 联合 DHS 似乎是实现这一目标的有效装置。增加抗旋螺钉可能通过提供两点固定进一步提高稳定性。
