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动力髋螺钉（DHS）微创治疗股骨转子间骨折

Minimally Invasive Osteosynthesis of Transtrochanteric Fractures with Dynamic Hip Screw (DHS).

作者信息

Guimarães José André Melo Barreto, Machado Marcos Cezar Feitosa de Paula, Galvão Pauliana Valéria Machado, de Lima Jéssika Cristina, Gomes Lucas Dos Santos, Guimarães Pedro Ferreira Barreto

机构信息

Hospital São Vicente, Serra Talhada, PE, Brasil.

Faculdade de Medicina (Campus Serra Talhada), Universidade de Pernambuco, Serra Talhada, PE, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2021 Feb;56(1):109-113. doi: 10.1055/s-0040-1716758. Epub 2020 Sep 25.

DOI:10.1055/s-0040-1716758
PMID:33627909
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7895623/
Abstract

The method presented here consists of a minimally invasive surgical technique for osteosynthesis of transtrochanteric fractures with (DHS) 135°. It is indicated in the treatment of 31-A1 and 31-A2 fractures (Arbeitsgemeinschaft für Osteosynthesefragen Classification - AO) that meet the prerequisites required for using DHS. The surgery is performed, preferably, before 48 hours after the fracture. With the use of the same instruments as the traditional surgical technique and the aid of the C-arm, a closed reduction of the fracture and implantation of the DHS is performed by a 2-cm surgical incision, through dissection of the underlying tissues, with minimal bleeding and damage to the soft parts. In the immediate postoperative period, the patient is encouraged to orthostatism and walk with full load, which anticipates hospital discharge and favors early functional rehabilitation. Outpatient return is scheduled at 2, 6, 12 and 24 weeks postoperatively, with radiographic evaluation to assess fracture healing.

摘要

本文介绍的方法包括一种用于135°动力髋螺钉（DHS）治疗转子间骨折的微创外科技术。该方法适用于治疗符合使用DHS所需前提条件的31 - A1和31 - A2型骨折（ Arbeitsgemeinschaft für Osteosynthesefragen分类 - AO）。手术最好在骨折后48小时内进行。使用与传统手术技术相同的器械并借助C型臂，通过2厘米的手术切口，在对深层组织进行解剖的情况下，对骨折进行闭合复位并植入DHS，术中出血极少，软组织损伤最小。术后即刻鼓励患者直立并负重行走，这可提前出院并有利于早期功能康复。术后2、6、12和24周安排门诊复诊，并进行影像学评估以评估骨折愈合情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a90/7895623/927eeef8275b/10-1055-s-0040-1716758-i2000148en-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a90/7895623/806bddfe1011/10-1055-s-0040-1716758-i2000148en-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a90/7895623/86c50f6418db/10-1055-s-0040-1716758-i2000148en-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a90/7895623/5606ed54ca11/10-1055-s-0040-1716758-i2000148en-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a90/7895623/1a19ef24c589/10-1055-s-0040-1716758-i2000148en-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a90/7895623/927eeef8275b/10-1055-s-0040-1716758-i2000148en-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a90/7895623/806bddfe1011/10-1055-s-0040-1716758-i2000148en-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a90/7895623/86c50f6418db/10-1055-s-0040-1716758-i2000148en-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a90/7895623/5606ed54ca11/10-1055-s-0040-1716758-i2000148en-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a90/7895623/1a19ef24c589/10-1055-s-0040-1716758-i2000148en-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a90/7895623/927eeef8275b/10-1055-s-0040-1716758-i2000148en-5.jpg

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Int J Surg. 2016 May;29:151-8. doi: 10.1016/j.ijsu.2016.03.065. Epub 2016 Apr 5.
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THE MINUS(®) SYSTEM MINIMALLY INVASIVE TECHNIQUE FOR THE TREATMENT OF TRANTROCHANTERIC FRACTURES.用于治疗转子间骨折的MINUS(®)系统微创技术
Rev Bras Ortop. 2015 Nov 16;47(1):113-7. doi: 10.1016/S2255-4971(15)30354-2. eCollection 2012 Jan-Feb.
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Lateral femoral wall thickness. A reliable predictor of post-operative lateral wall fracture in intertrochanteric fractures.
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In Silico Finite Element Modeling of Stress Distribution in Osteosynthesis after Pertrochanteric Fractures.转子间骨折后骨内固定应力分布的计算机有限元建模
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Outcomes of minimally invasive osteosynthesis of intertrochanteric fractures with dynamic hip screw: A prospective case series.动力髋螺钉微创治疗股骨转子间骨折的疗效：一项前瞻性病例系列研究。
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