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通过微创开放入路进行环扎钢丝辅助复位经头髓内固定治疗的转子下骨折:手术技术

Cerclage Wiring Through a Mini-Open Approach to Assist Reduction of Subtrochanteric Fractures Treated With Cephalomedullary Fixation: Surgical Technique.

作者信息

Codesido Pablo, Mejía Ana, Riego Jonathan, Ojeda-Thies Cristina

机构信息

*Department of Traumatology and Orthopaedic Surgery, Lucus Augusti University Hospital, Lugo, Spain; and †Trauma Unit, Department of Traumatology and Orthopaedic Surgery, 12 de Octubre University Hospital, Madrid, Spain.

出版信息

J Orthop Trauma. 2017 Aug;31(8):e263-e268. doi: 10.1097/BOT.0000000000000871.

Abstract

Despite advances in the management of subtrochanteric fractures, in particular with the use of cephalomedullary nails, outcomes remain worse than other fractures of the proximal femur. Because an anatomic reduction is needed to offer the best results, several methods of reduction, using clamps and wires have been described. Reduction of fractures in elderly patients is especially complicated because of poor bone quality, comorbidities, and unfavorable fracture patterns. We describe a new technique of reduction and cerclage wiring through a mini-open approach for isolated subtrochanteric, as well as intertrochanteric fractures with extension into the subtrochanteric area, and report our results in a series of patients.

摘要

尽管在转子下骨折的治疗方面取得了进展,特别是在使用髓内钉方面,但与股骨近端的其他骨折相比,其治疗结果仍然较差。由于需要解剖复位才能获得最佳效果,因此已经描述了几种使用夹子和钢丝的复位方法。老年患者的骨折复位尤其复杂,因为骨质质量差、合并症以及骨折类型不佳。我们描述了一种通过微创开放入路进行复位和环扎钢丝固定的新技术,用于孤立的转子下骨折以及延伸至转子下区域的转子间骨折,并报告了我们一系列患者的治疗结果。

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