Ceder L, Lunsjö K, Olsson O, Stigsson L, Hauggaard A
Department of Orthopedics, Helsingborg Hospital, Sweden.
Clin Orthop Relat Res. 1998 Mar(348):101-6.
Thirty-two consecutive subtrochanteric fractures in 32 patients were stabilized using the Medoff sliding plate and were followed up prospectively for 1 year. Two patients died during the first postoperative year. Twenty-nine of the remaining 30 (97%) fractures united by 1-year followup. Two types of plate dynamization schema were used: uniaxial (17 patients) and biaxial (15 patients). With uniaxial dynamization, plate sliding averaged 12 mm along the femoral shaft without medialization of the femoral shaft. With biaxial dynamization along the femoral shaft and the neck, plate sliding averaged 11 mm and screw in barrel sliding averaged 9 mm; medialization of the femoral shaft ranged from 0% to 35% of the femoral shaft diameter. Three fractures treated with uniaxial dynamization had migration of the lag screw within the femoral head; all three fractures united without additional screw migration after secondary or staged biaxial plate dynamization.
采用Medoff滑动钢板对32例患者的32例连续性转子下骨折进行固定，并进行了为期1年的前瞻性随访。2例患者在术后第一年死亡。其余30例骨折中的29例（97%）在1年随访时愈合。使用了两种钢板动力化方案：单轴（17例患者）和双轴（15例患者）。单轴动力化时，钢板沿股骨干平均滑动12 mm，股骨干无内移。双轴动力化时，沿股骨干和股骨颈方向，钢板平均滑动11 mm，套筒内螺钉平均滑动9 mm；股骨干内移范围为股骨干直径的0%至35%。3例接受单轴动力化治疗的骨折出现拉力螺钉在股骨头内移位；在二次或分期双轴钢板动力化后，所有3例骨折均愈合且螺钉无进一步移位。
