Olsson O, Ceder L, Lunsjö K, Hauggaard A
Department of Orthopedics, Helsingborg Hospital, Sweden.
Acta Orthop Scand. 1997 Aug;68(4):327-31. doi: 10.3109/17453679708996171.
In a prospective study, 94 consecutive patients with unstable intertrochanteric fractures were treated by 16 surgeons, using a modified 4-hole Medoff sliding plate and followed clinically and radiographically for 1 year. Weight bearing after surgery was allowed as tolerated. This new device is smaller and uses a simpler technique of insertion than the original 6-hole Medoff sliding plate. The modification of the plate makes biaxial sliding along both the shaft and the neck of the femur obligatory. All fractures united and no postoperative lag screw penetration occurred. The use of a shorter side-plate with 4 cortical bone screws was sufficient for fixation and no plate loosening or breakage was observed. On the basis of this experience, biaxial dynamization seems to facilitate fracture impaction and stability, and the simplified 4-hole Medoff sliding plate appears to be a suitable method for the treatment of unstable intertrochanteric fractures.
在一项前瞻性研究中，16位外科医生使用改良的4孔梅多夫滑动钢板，对94例连续的不稳定型股骨转子间骨折患者进行了治疗，并进行了为期1年的临床和影像学随访。术后允许患者根据耐受情况负重。这种新装置比原来的6孔梅多夫滑动钢板更小，插入技术更简单。钢板的改良使得沿股骨干和股骨颈的双轴滑动成为必然。所有骨折均愈合，未发生术后拉力螺钉穿透。使用带有4枚皮质骨螺钉的较短侧板足以进行固定，未观察到钢板松动或断裂。基于这一经验，双轴动力化似乎有助于骨折嵌插和稳定，简化的4孔梅多夫滑动钢板似乎是治疗不稳定型股骨转子间骨折的一种合适方法。
