Apel D M, Patwardhan A, Pinzur M S, Dobozi W R
Department of Orthopaedics and Rehabilitation, Loyola University Medical Center, Maywood, Illinois.
Clin Orthop Relat Res. 1989 Sep(246):156-64.
An experimental four-part unstable intertrochanteric (IT) femoral fracture was created with either a large or small posteromedial fragment (PMF). Sixty-eight adult embalmed femoral anatomic specimens were fractured and subjected to axial loading after fixation. The maximum load prior to failure for femora from the same anatomic specimen was compared to differentiate between different methods of fixation. In the presence of the large PMF variation, anatomic reduction and fixation allowed the femur to resist an average maximum load 57% greater than identical fractures with the fragment excluded. Fixation of the small PMF increased construct strength by an average of 17% over no fixation. The PMF is the keystone to mechanical stability for IT fractures of the femur. When anatomic reduction is possible, its fixation becomes progressively more critical as its size increases.
制作了一种实验性的四部分不稳定型股骨转子间骨折，带有一个大的或小的后内侧骨折块（PMF）。对68个成年防腐处理的股骨解剖标本进行骨折并在固定后施加轴向载荷。比较来自相同解剖标本的股骨在失效前的最大载荷，以区分不同的固定方法。在存在大的PMF变异的情况下，解剖复位和固定使股骨能够承受的平均最大载荷比排除该骨折块的相同骨折大57%。与未固定相比，小PMF的固定使结构强度平均提高了17%。PMF是股骨转子间骨折机械稳定性的关键。当可以进行解剖复位时，随着其尺寸增加，对其进行固定变得越来越关键。
