Schulz R, Mollenhauer I, Boenick U
Institut für Medizintechnik, Technische Universität Berlin.
Biomed Tech (Berl). 1997 Dec;42(12):352-7. doi: 10.1515/bmte.1997.42.12.352.
The current success of the treatment of trochanteric fractures of the femur still depends on the type of fracture involved. A number of surgical procedures have proved successful in the treatment of stable fractures (e.g. dynamic hip screw, gamma nail). However, the treatment of unstable fractures remains a problem. With this type of fracture the implant is exposed to very unfavourable biomechanical loading that often leads to failure of the osteosynthesis, and makes removal of the implant necessary. In extensive tests, the biomechanical loading capacity of a new Y-nail has been investigated as a function of the stability and location of the fracture. The results show that this form of intramedullary fixing is suitable for both stable and unstable fractures. Unstable, far distal subtrochanteric fractures of the femur remain borderline indications.
目前股骨转子间骨折的治疗成功与否仍取决于所涉及的骨折类型。一些外科手术已被证明在治疗稳定型骨折（如动力髋螺钉、伽马钉）方面是成功的。然而，不稳定型骨折的治疗仍然是一个问题。对于这种类型的骨折，植入物会受到非常不利的生物力学负荷，这常常导致骨合成失败，并使得有必要取出植入物。在大量测试中，研究了一种新型Y形钉的生物力学负荷能力与骨折稳定性和位置的关系。结果表明，这种髓内固定形式适用于稳定型和不稳定型骨折。股骨极远端不稳定的转子下骨折仍然是边缘适应症。
