Osterwalder A, Dietschi C, Martinoli S
Z Orthop Ihre Grenzgeb. 1985 Mar-Apr;123(2):193-200. doi: 10.1055/s-2008-1045134.
The report is based on a follow-up of over 54 osteosyntheses employing the Dynamic Hip Screw (DHS) of the AO on the proximal femur. The patients, of an average age of 72 years, exhibited the following lesions: fractures of 7 femoral necks, 43 fractures in the pertrochanteric region, 3 reverse fractures and 1 subtrochanteric metastasis. An unstable fracture was present on 26 occasions. The follow-up, carried out personally, was done from 3 to 26 months postoperatively on 38 out of 40 patients still alive. The average age was 68 years. In not a single case was an implant failure or a protrusion of the screw into the joint observed. Technical faults were present in 4 cases (7.4%) that led in 1 case to an infection (1.85%). 37 patients (97%), of which 23 were between 70 and 90 years of age, were able to walk during the follow-up. 34 (89%) of the patients showed symmetrical, or less than 20 degrees of limited hip movement while 12 (32%) sporadically complained of slight pain or weather dependency. 2 of the 7 patients with femoral neck fractures and 4 of the remaining 47 patients with trochanteric fractures (including 1 subtrochanteric metastasis) had to be reoperated. The DHS proved to be a simple and efficient fixation device for proximal femoral fractures in the hands of ten different surgeons. The telescopic sliding of the screw enables a compulsory sintering of the fracture, without leading to penetration of the femoral head or breakage of the implant.
该报告基于对54例以上采用AO动力髋螺钉（DHS）治疗股骨近端骨折的随访。患者平均年龄72岁，表现出以下损伤：7例股骨颈骨折，43例转子间区域骨折，3例反转子骨折和1例转子下转移瘤。26例为不稳定骨折。亲自进行的随访是在40例仍存活患者中的38例术后3至26个月进行的。平均年龄为68岁。未观察到1例植入物失败或螺钉突入关节的情况。4例（7.4%）存在技术失误，其中1例导致感染（1.85%）。37例患者（97%）能够行走，其中23例年龄在70至90岁之间。34例（89%）患者髋关节活动对称或受限小于20度，12例（32%）偶尔抱怨轻微疼痛或天气变化时疼痛。7例股骨颈骨折患者中的2例以及其余47例转子间骨折患者（包括1例转子下转移瘤）中的4例不得不再次手术。在十位不同外科医生手中，DHS被证明是一种用于股骨近端骨折的简单有效的固定装置。螺钉的伸缩滑动能够强制骨折愈合，而不会导致股骨头穿透或植入物断裂。
