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采用带双孔侧板的135度滑动螺钉治疗股骨粗隆间骨折的结果

Results of intertrochanteric femur fractures treated with a 135-degree sliding screw with a two-hole side plate.

作者信息

Bolhofner B R, Russo P R, Carmen B

机构信息

Bayfront Medical Center, St. Petersburg, Florida, USA.

出版信息

J Orthop Trauma. 1999 Jan;13(1):5-8. doi: 10.1097/00005131-199901000-00002.

Abstract

OBJECTIVE

To observe and report the clinical results of the treatment of intertrochanteric hip fractures treated with a 135-degree hip screw with a two-hole side plate.

DESIGN

Prospective consecutive.

SETTING

Community private practice.

PATIENTS

A consecutive series of seventy primarily older patients with intertrochanteric hip fractures treated in a community hospital setting.

INTERVENTION

Surgical treatment with a 135-degree sliding hip screw and a two-hole side plate.

MAIN OUTCOME MEASUREMENTS

Healing rate and time, operative blood loss and time, incidence of hardware failure, and complications including loss of side plate fixation and amount of collapse.

RESULTS

Sixty-nine patients, with seventy intertrochanteric hip fractures, underwent surgical treatment with a 135-degree sliding hip screw and a two-hole side plate. There were twenty-one (30 percent) A1.1, sixteen (23 percent) A1.2, twenty-one (30 percent) A2.1, and twelve (17 percent) A2.2 fractures in twenty-three (33 percent) men and forty-six (67 percent) women. Average age was seventy-nine years. The average estimated blood loss was seventy-seven cubic centimeters (range 10 to 300 cubic centimeters), and the average surgical time was thirty-one minutes (range 8 to 90 minutes). The average time to union was fifteen weeks (range 8 to 17 weeks). There were three failures: two from screw cut-out and one from screw plate dissociation. No cases failed due to loss of fixation of the two-hole side plate. Collapse was minimum in fifty-five patients (79 percent), moderate in twelve patients (17 percent), and severe in two patients (3 percent).

CONCLUSIONS

Use of the 135-degree sliding hip screw with a two-hole side plate produces satisfactory healing and results in relatively low blood loss and short surgical times without the loss of side plate fixation.

摘要

目的

观察并报告采用带双孔侧板的135°髋螺钉治疗股骨转子间骨折的临床结果。

设计

前瞻性连续研究。

地点

社区私人诊所。

患者

在社区医院环境中接受治疗的一系列连续70例主要为老年股骨转子间骨折患者。

干预措施

采用135°滑动髋螺钉和双孔侧板进行手术治疗。

主要观察指标

愈合率和愈合时间、术中失血量和手术时间、内固定失败发生率以及包括侧板固定丧失和塌陷量在内的并发症。

结果

69例患者(共70处股骨转子间骨折)接受了采用135°滑动髋螺钉和双孔侧板的手术治疗。其中男性23例(33%),女性46例(67%),A1.1型骨折21例(30%),A1.2型骨折16例(23%),A2.1型骨折21例(30%),A2.2型骨折12例(17%)。平均年龄为79岁。平均估计失血量为77立方厘米(范围10至300立方厘米),平均手术时间为31分钟(范围8至90分钟)。平均愈合时间为15周(范围8至17周)。出现3例失败:2例因螺钉穿出,1例因螺钉钢板分离。未出现因双孔侧板固定丧失导致失败的病例。55例患者(79%)塌陷最小,12例患者(17%)塌陷中度,2例患者(3%)塌陷严重。

结论

使用带双孔侧板的135°滑动髋螺钉可实现满意的愈合,术中失血相对较少,手术时间短,且不会出现侧板固定丧失的情况。

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