- 期刊
Results of Unstable Peritrochanteric Fractures Treated with Dynamic Hip Screws (DHS) Fixation with or without Trochanter Stabilizing Plate (TSP) Augmentation
動態髖螺釘聯合粒隆支持鋼板與動態髖螺釘應用於股骨粗隆周圍骨折之治療結果比較
摘要
背景及目標：爲了評估動態髖螺釘聯合粗隆支持鋼板用於治療股骨粗隆周圍骨折特別是不穩定之骨折的效果。 方法：本文回顧183個股骨粗隆周圍骨折的病人，從2002年8月至2007年4月，其中動態髖螺釘及粗隆支持鋼板組及髖螺釘組追蹤一年以上者分別有25及17人，所有的股骨粗隆周圍骨折是特別根據AO來做分類。 結果：粗隆支持鋼板可以避免股骨幹的過度塌陷及往內側位移及減少動力髖螺釘的位移，同時可以避免大轉子骨往外偏移，其中一個病人因爲內固定失敗及發生術後股骨頸骨折而接受雙極式人工半髖關節置換術。動態髖螺釘及粗隆支持鋼板組和動力髖螺釘組的平均滑動距離分別爲5.9毫米和11.2毫米，在動態髖螺釘及粗隆支持鋼板組抗旋轉螺釘被應用於5個病人以避免近端股骨頭及股骨頸骨折之旋轉。 結論：粗隆支持鋼板合併動態髖螺釘可以避免股骨粗隆周圍骨折之過度滑動及骨折遠端往內偏移。因此使用粗隆支持鋼板可減少動態髖螺釘的位移，同時不影響骨折之癒合。
關鍵字
無資料並列摘要
Objectives: To evaluate the outcomes of surgical treatment of unstable peritrochanteric fractures with dynamic hip screws (DHS) enhanced with a trochanter stabilizing plate (TSP). Methods: We retrospectively reviewed the records of 183 patients with peritrochanteric fracture including subtrochanteric fracture and reverse obliquity fracture of the intertrochanteric region treated between August 2002 and April 2007. Twenty-five patients in the TSP with DHS group and 17 patients in the DHS group were followed up for at least one year. All peritrochanteric hip fractures were classified by OTA criteria, which are based on the AO classification. Results: TSP prevented excessive collapse, medial translation of the femoral shaft and excessive sliding of the lag screw. Lateralization of the greater trochanter was successfully prevented. In one patient the operation was converted to bipolar hemiarthroplasty because of postoperative femoral neck fracture and implant failure. The mean sliding distance in the TSP with DHS group was 5.9 mm, and in the DHS group was 11.2 mm. Anti-rotation screws were used in 5 patients in the TSP+DHS group to prevent rotation of the head-neck fragments. Conclusion: In comparison with conventional DHS, the TSP superimposed on DHS not only prevented excessive telescoping and medialization of the distal fracture fragment, but also reduced excessive secondary lag screw sliding without affecting fracture healing.
延伸閱讀
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