Barrios C, Walheim G, Broström L A, Olsson E, Stark A
Department of Orthopedics, Karolinska Hospital and Institute, Stockholm, Sweden.
Clin Orthop Relat Res. 1993 Sep(294):187-92.
The influence of several clinical and radiographic parameters on the functional outcome of 92 patients with trochanteric hip fractures treated at random with either Ender nails or a sliding screw plate (SSP) was prospectively investigated. Apart from other clinical variables such as pain, the use of walking aids, and walking distance, the walking ability of patients was assessed by gait analysis performed on an electronic walkway. The parameters investigated were the maximal vertical force (MVF) and single-limb support phase (SLS). Independent of the type of fixation, no differences were observed between stable and unstable fractures in any of the parameters analyzed six months after surgery. In fractures treated with Ender nails, the use of walking aids and MVF were influenced by a satisfactory fracture reduction. Walking distance was the sole factor correlated with the status of fracture healing. In fractures treated with SSP, the pain was the only clinical variable significantly influenced by the outcome of fracture healing. In trochanteric fractures treated with Ender nails, the quality of fracture reduction was the most valuable predictor of patients' recovery of walking ability.
前瞻性研究了92例转子间髋部骨折患者，随机采用Ender钉或滑动螺钉钢板（SSP）治疗，多种临床和影像学参数对其功能结局的影响。除疼痛、助行器使用情况和行走距离等其他临床变量外，还通过在电子步道上进行步态分析来评估患者的行走能力。所研究的参数为最大垂直力（MVF）和单腿支撑期（SLS）。与固定类型无关，术后6个月分析的任何参数在稳定和不稳定骨折之间均未观察到差异。在用Ender钉治疗的骨折中，助行器的使用和MVF受骨折复位情况良好的影响。行走距离是与骨折愈合状态相关的唯一因素。在用SSP治疗的骨折中，疼痛是受骨折愈合结果显著影响的唯一临床变量。在用Ender钉治疗的转子间骨折中，骨折复位质量是患者行走能力恢复的最有价值预测指标。
