Department of Surgery and Anesthesiology II, Xi'an Honghui Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, 710054, P. R. China.
Department of Burn and Microsurgery, The People's Hospital of Ankang, Ankang, Shaanxi Province, 725000, P.R. China.
J Orthop Surg Res. 2021 Apr 29;16(1):285. doi: 10.1186/s13018-021-02430-5.
To investigate the clinical efficacy of locking compression plate fixation for the treatment of femoral intertrochanteric fractures in patients with preexisting proximal femoral deformity.
A retrospective analysis was conducted on 37 patients with femoral intertrochanteric fractures combined with preexisting proximal femoral deformity between January 2013 and July 2019. The patients included 24 males and 13 females aged from 23 to 69 years old, with an average age of 47.5 years. The preexisting proximal femoral deformities resulted from poliomyelitis sequela, proximal femoral fibrous dysplasia, malunion and implant failure combined with coxa vara after intramedullary nailing fixation. There were 6 cases of 31-A2.1, 6 cases of 31-A2.2, 20 cases of 31-A3.1, and 5 cases of 31-A3.2, determined based on the AO classification of intertrochanteric fractures. All fractures were managed through open reduction and locking plate fixation. The hip disability and osteoarthritis outcome score (HOOS) was used to assess hip function before injury and at the last postoperative follow-up. The short form 36 (SF-36) Health Survey Questionnaire was used to assess quality of life.
Thirty-seven patients were followed up for 12 to 27 months (average, 20.7 months). All patients achieved bone healing within 5.1 months on average (range, 3 to 6 months). Postoperative complications included deep vein thrombosis in three patients, bedsores in one and delayed union in one patient. No other complications, such as surgical site infection, fat embolism, nonunion and re-fracture, were presented. There was no significant difference in the HOOS scores and the SF-36 Health Questionnaire outcomes at pre-injury and at the last postoperative follow-up (p > 0.05).
It is difficult to perform intramedullary fixation of femoral intertrochanteric fractures in patients with preexisting proximal femoral deformity, while locking compression plate fixation is a simple and effective method of treatment.
探讨锁定加压钢板固定治疗合并股骨近端畸形的股骨转子间骨折的临床疗效。
回顾性分析 2013 年 1 月至 2019 年 7 月收治的 37 例合并股骨近端畸形的股骨转子间骨折患者的临床资料，男 24 例，女 13 例；年龄 23~69 岁，平均 47.5 岁。股骨近端畸形原因为小儿麻痹后遗症、股骨近端纤维结构不良、骨折畸形愈合及髓内钉固定后并发髋内翻，AO 分型：31-A2.1 型 6 例，31-A2.2 型 6 例，31-A3.1 型 20 例，31-A3.2 型 5 例。均采用切开复位锁定钢板固定治疗。采用髋关节功能障碍和骨关节炎结局评分（HOOS）评估术前及末次随访时髋关节功能，采用简明健康状况量表（SF-36）评价生活质量。
37 例获得随访，时间 1227 个月，平均 20.7 个月。所有患者骨折均愈合，愈合时间平均 5.1 个月（36 个月）。术后并发症：深静脉血栓形成 3 例，压疮 1 例，延迟愈合 1 例。无手术部位感染、脂肪栓塞、骨折不愈合、再骨折等并发症发生。HOOS 评分及 SF-36 量表各维度评分术前与末次随访时比较差异均无统计学意义（P＞0.05）。
合并股骨近端畸形的股骨转子间骨折，髓内固定困难，锁定加压钢板固定是一种简单、有效的治疗方法。
