Yoshikawa Ryo, Hiranaka Takafumi, Kamenaga Tomoyuki, Niikura Takahiro, Sakai Yoshitada, Kuroda Ryosuke
Department of Orthopedic Surgery and Joint Surgery Center, Takatsuki General Hospital, Takatsuki, Osaka, Japan.
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan.
J Orthop Case Rep. 2022 Feb;12(2):49-52. doi: 10.13107/jocr.2022.v12.i02.2662.
A new device, TresLock (KISCO DIR Co., Ltd., Kobe), has been used for the treatment of unstable proximal femoral fractures and was designed based on Japanese anatomical characteristics. It has three sliding hip screws with one side plate. The angle of all screws relative to the plate has been set to 128°, and each hip screw has a short thread (15 mm) to prevent crossing of the fracture line. In this study, we evaluated the morphological compatibility of TresLock.
We treated 10 patients with hip fractures using TresLock at our institution between September 2016 and December 2017. The average age of the patients was 83.8 years (range, 73-93 years). Fractures included five proximal neck transcervical shear fractures (Orthopaedic Trauma Association [OTA] type-31B2.3, Pauwels III) and five basicervical fractures (OTA type-31B3). The clinical course and three-dimensional computed tomography were evaluated postoperatively.
In all cases, all three screws were inserted within the femoral neck. The screws were inserted at an axis of 2.5 ± 1.3° varus to the femoral neck axis. The distance from the subcapital line to the three (proximal-anterior, proximal-posterior, and distal) screw thread ends was 12.0 ± 1.8 mm, 10.4 ± 2.4 mm, and 11.6 ± 4.0 mm, respectively and was sufficient to actuate compression force. However, one case (Pauwels III) required reoperation because of non-union.
Careful follow-up is needed, but TresLock shows good anatomical compatibility for femurs among the Japanese population.
一种新型装置TresLock（神户KISCO DIR有限公司）已用于治疗不稳定型股骨近端骨折，该装置基于日本人体解剖学特征设计。它有三个滑动髋螺钉和一个侧板。所有螺钉相对于侧板的角度设定为128°，每个髋螺钉有一个短螺纹（15毫米）以防止骨折线交叉。在本研究中，我们评估了TresLock的形态学兼容性。
2016年9月至2017年12月期间，我们在本机构使用TresLock治疗了10例髋部骨折患者。患者的平均年龄为83.8岁（范围73 - 93岁）。骨折包括五例近端经颈剪切骨折（骨科创伤协会[OTA]31B2.3型， Pauwels III型）和五例基底部骨折（OTA 31B3型）。术后对临床病程和三维计算机断层扫描进行了评估。
在所有病例中，所有三个螺钉均插入股骨颈内。螺钉以相对于股骨颈轴线内翻2.5±1.3°的轴线插入。从股骨头下骨皮质线到三个（近端前侧、近端后侧和远端）螺钉螺纹末端的距离分别为12.0±1.8毫米、10.4±2.4毫米和11.6±4.0毫米，足以产生压缩力。然而，有一例（Pauwels III型）因骨不连需要再次手术。
需要仔细随访，但TresLock在日本人群中对股骨显示出良好的解剖学兼容性。
