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[动力髋螺钉(DHS)内固定术治疗髋部股骨骨折及该方法在这类损伤治疗中的地位]

[DHS (Dynamic Hip Screw)-osteosynthesis in the management of femoral fractures in the hip region and the place of this method in the treatment of such injuries].

作者信息

Fröhlich P, Benkö T

机构信息

Országos Traumatológiai Intézet közleménye.

出版信息

Magy Traumatol Ortop Kezseb Plasztikai Seb. 1993;36(1):59-64.

PMID:8343835
Abstract

In the last four years we performed 182 osteosynthesizes with Dynamic Hip Screw, besides other methods on the fractures of the hip region. Here we are presenting the evaluation of our results, which, regarding the international scene, fall into the medium category. The operations were performed within three days after the injuries in 61 per cent of our patients. Our results are good in 80 per cent of our patients. The incidence of method-specific complications is 15 per cent in our statistics/such as wound haematomas, local infections, cut out of the device of the femoral head, metal failures, the fracture of the femur at the site of the introduction of the device). The rate of complications is 30 per cent in case of Ender nailing. More than a 1 cm shortening in the fracture after weight bearing was observed in the 47 per cent of our DHS cases. Patients who are complaining of pain during weight bearing belong to this group. In accordance with other authors, we consider the DHS osteosynthesis, due to its high stability, the best technique in case of unstable pertochanteric fractures of elderly patients. We recommend the angular plate fixation to the pertrochanteric fractures in young patients, in whose case it requires a more accurate reposition and who are able to walk without weight bearing. We can achieve good results with Ender nails in case of stable pertrochanteric fractures of elderly patients.

摘要

在过去四年中,我们除了采用其他方法治疗髋部骨折外,还使用动力髋螺钉进行了182例骨固定术。在此,我们展示对结果的评估,就国际范围而言,这些结果属于中等水平。61%的患者在受伤后三天内接受了手术。我们80%的患者结果良好。在我们的统计中,特定方法并发症的发生率为15%(如伤口血肿、局部感染、股骨头内固定装置脱出、金属断裂、股骨在植入装置部位骨折)。使用恩德勒髓内钉时并发症发生率为30%。在我们的动力髋螺钉病例中,47%的患者在负重后骨折处缩短超过1厘米。主诉负重时疼痛的患者属于这一组。与其他作者一致,我们认为由于动力髋螺钉固定具有高稳定性,对于老年患者不稳定的股骨转子周围骨折而言是最佳技术。对于年轻患者的股骨转子周围骨折,我们推荐使用角钢板固定,此类患者需要更精确的复位且能够不负重行走。对于老年患者稳定的股骨转子周围骨折,使用恩德勒髓内钉我们可以取得良好效果。

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