Orthopaedic Department, Sohag Teaching Hospital, General Organization for Teaching Hospitals and Institutions, Tahta 15 St., Sohag, Egypt.
Int Orthop. 2010 Apr;34(4):577-82. doi: 10.1007/s00264-009-0814-1. Epub 2009 May 28.
We prospectively studied 42 patients in order to identify a group of proximal femoral fractures having liability for axial and rotational instability, and to present results of their fixation using the dynamic hip screw (DHS) with derotation screw (DRS). At 12 months postoperatively, patients were functionally evaluated and the radiological outcome was analysed. All fractures united within an average period of 11.5 weeks. The mean sliding distance was 5.5 mm and mean shortening of the limbs was 2 mm. According to the criteria of Kyle et al. (J Bone Joint Surg [Am] 61-A:216-221), 39 patients obtained excellent results, two good and one fair. We conclude that the AO types B2.1, A1.1, A2.1, A2.2 and A2.3 have a common instability denominator and therefore should be treated alike. The sliding component of the DHS allows solid fixation of the two major fragments in two planes and the DRS in the third plane.
我们前瞻性地研究了 42 例患者，目的是确定一组股骨近端骨折，这些骨折具有轴向和旋转不稳定性，并介绍使用动力髋螺钉（DHS）加旋转移位螺钉（DRS）固定的结果。术后 12 个月，对患者进行了功能评估，并对影像学结果进行了分析。所有骨折均在平均 11.5 周内愈合。滑动距离平均为 5.5 毫米，肢体平均缩短 2 毫米。根据 Kyle 等人的标准（J Bone Joint Surg [Am] 61-A:216-221），39 例患者获得了优秀的结果，2 例良好，1 例一般。我们得出结论，AO 分型 B2.1、A1.1、A2.1、A2.2 和 A2.3 具有共同的不稳定因素，因此应采用相同的治疗方法。DHS 的滑动部分可在两个平面上牢固固定两个主要骨折块，DRS 则可在第三个平面上固定。
