Bombah F M, Diawara M, Ekani B Y, Nana T, Mikiela A
Department of Surgery, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon.
Orthopedic and Traumatologic Surgery Department, Army Instructional Hospital, Libreville, Gabon.
Case Rep Orthop. 2021 Oct 4;2021:4177203. doi: 10.1155/2021/4177203. eCollection 2021.
The DHS system is an effective means of open reduction and internal fixation of proximal femur fractures. Postoperative complications are little described and deserve to be studied for better preventive and curative treatment. We report the observations of five (5) patients who presented postoperative complications specific to the DHS system at army instructional Hospital-Libreville. These described complications are related to deterioration of internal fixation leading to callus, nonunion, or infection. Those found are the cut out phenomenon, avascular necrosis of the femoral head, and the fracture of the DHS system. All these complications required surgical revision without functional repercussions at the last follow-up. Complications of internal fixation by the DHS system can be avoided by rigorous asepsis, adequate indications for surgery, and rigorous surgical techniques. Good management can restore hip function.
动力髋螺钉(DHS)系统是股骨近端骨折切开复位内固定的有效手段。术后并发症鲜有描述,为了更好地进行预防和治疗,值得对此展开研究。我们报告了在利伯维尔陆军教学医院出现DHS系统特定术后并发症的5例患者的观察情况。这些所述并发症与内固定物失效导致骨痂形成、骨不连或感染有关。发现的并发症有切割现象、股骨头缺血性坏死以及DHS系统断裂。所有这些并发症均需要手术翻修,在末次随访时未出现功能障碍。通过严格的无菌操作、适当的手术指征以及严谨的手术技术,可以避免DHS系统内固定的并发症。良好的处理能够恢复髋关节功能。