Orthopaedic Department of 3rd Faculty of Medicine, Charles University, Prague, Czech Republic.
Int Orthop. 2010 Aug;34(6):877-82. doi: 10.1007/s00264-009-0840-z.
Pertrochanteric fracture in a group of 41 patients was internally fixed using a DHS with a two-hole side-plate. There were 20 male and 21 female patients with a mean age of 74 years. Thirty-two patients were followed up for more than one year and their final results were evaluated. There were 30 stable (31A1) and only two unstable (31A2) fractures. The average surgical time was 28 minutes, the average length of incision was 5.5 cm. All the patients, with one exception, healed without complications in anatomical position with good function of the hip joint. The only complication was caused by pulling-out of the plate from the femur in the fourth postoperative week when the patient (31A2 fracture) fell out of bed. A DHS with a four-hole side-plate was used at reoperation; subsequently the fracture had healed. Based on the results in this series of patients, the authors recommend fixation of stable pertrochanteric fractures with DHS and a two-hole side-plate. As proven by the authors, the benefit of DHS with a two-hole side-plate as compared to DHS with a four-hole side-plate is a shorter surgical time (28 and 36 minutes, respectively).
41 例股骨转子间骨折患者采用 DHS 加两孔侧钢板内固定。其中男 20 例,女 21 例,平均年龄 74 岁。32 例患者随访 1 年以上,最终评估其结果。其中 30 例稳定(31A1),仅 2 例不稳定(31A2)骨折。平均手术时间 28 分钟,平均切口长度 5.5cm。除 1 例外,所有患者均在解剖位置愈合,无并发症,髋关节功能良好。唯一的并发症是在术后第 4 周,当患者(31A2 骨折)从床上摔下时,钢板从股骨中拔出。再次手术时使用 DHS 加四孔侧钢板;随后骨折愈合。基于本系列患者的结果,作者建议 DHS 加两孔侧钢板固定稳定的股骨转子间骨折。正如作者所证明的,与 DHS 加四孔侧钢板相比,DHS 加两孔侧钢板的优势在于手术时间更短(分别为 28 分钟和 36 分钟)。