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小转子复位固定器在不稳定型股骨粗隆间骨折治疗中的应用。

Application of lesser trochanteric reduction fixator in the treatment of unstable intertrochanteric fractures.

作者信息

Hui Yao-Min, Zeng Guang, Liu Pei-Yi, Chai Bin

机构信息

Department of Orthopedics, Tong Ren Hospital, School of Medicine Shanghai Jiao Tong University, Shanghai 200336, China.

出版信息

World J Clin Cases. 2023 Sep 6;11(25):5863-5869. doi: 10.12998/wjcc.v11.i25.5863.

Abstract

BACKGROUND

Closed reduction and internal fixation with intramedullary nails has been widely accepted for treating intertrochanteric fractures.

AIM

To focus on how to avoid displacement of the lesser trochanter in unstable intertrochanteric fractures.

METHODS

We developed a lesser trochanteric reduction fixator for treating intertrochanteric fractures through fixing the lesser trochanter by combining the loop plate through the fixator after reduction by the reducer. Five patients with intertrochanteric fractures treated with the newly developed lesser trochanteric reduction fixator and loop plate combined with intramedullary nails, and 20 patients with intertrochanteric fractures treated with simple intramedullary nails were selected from December 2020 to March 2021.

RESULTS

The postoperative Harris hip score was significantly higher in patients treated with the lesser trochanteric reduction fixator than in patients treated without the lesser trochanteric reduction fixator, which indicated that this lesser trochanteric reduction fixator had a positive impact on rehabilitation of the hip joint after surgery and could significantly improve the quality of life of patients.

CONCLUSION

We fully realize the significance of trochanteric reduction and fixation, namely, reconstruction of structures under pressure, in the treatment of intertrochanteric fractures. As long as the general condition of patients is favorable and they are willing to undergo surgery, fixation of the main fracture end should be performed and the lesser trochanter should be reduced and fixed at the same time.

摘要

背景

闭合复位髓内钉内固定已被广泛用于治疗股骨转子间骨折。

目的

关注如何避免不稳定型股骨转子间骨折中小转子的移位。

方法

我们研发了一种用于治疗股骨转子间骨折的小转子复位固定器,通过在复位器复位后,利用固定器将环形钢板与小转子相结合来固定小转子。从2020年12月至2021年3月,选取了5例采用新研发的小转子复位固定器和环形钢板联合髓内钉治疗的股骨转子间骨折患者,以及20例采用单纯髓内钉治疗的股骨转子间骨折患者。

结果

采用小转子复位固定器治疗的患者术后Harris髋关节评分显著高于未采用小转子复位固定器治疗的患者,这表明该小转子复位固定器对术后髋关节康复有积极影响,能显著提高患者生活质量。

结论

我们充分认识到转子复位固定在股骨转子间骨折治疗中的重要性,即在压力下重建结构。只要患者一般情况良好且愿意接受手术,就应进行主要骨折端的固定,同时对小转子进行复位和固定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc7f/10506024/1121e1455a37/WJCC-11-5863-g001.jpg

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