【摘要】 目的分析股骨近端锁定钢板治疗股骨转子间骨折内固定失败的原因,提出避免并发症的方法。方法对我院2009年11月~2011年12月间采用股骨近端锁定钢板手术治疗的66例股骨转子间骨折进行回顾性分析,总结骨折类型、骨骼质量及骨折复位质量,分析造成手术失败的可能原因。结果共发现9例失败病例,失败率13.64%。6例发生钢板断裂,1例发生螺钉退出,2例螺钉切割。骨折类型:EvansⅢ型2例,Ⅳ型4例,Ⅴ型3例。Singh指数评定骨质量:Ⅴ级1例,Ⅳ级2例,Ⅲ级2例,Ⅱ级4例。结论病例选择不当、骨折复位不良、以及骨骼质量差均是股骨近端解剖钢板治疗股骨转子间骨折手术失败的原因,正确的手术指征和精确的手术操作是成功的关键。更多还原

【Abstract】 Objective To analyze the failure of internal fixation on femoral intertrochanteric fracture with locking proximal femoral bone plate﹙LPFP﹚in order to indicate the methods for avoiding the complications.Methods A retrospective study of 66 patients treated in internal fixation with locking proximal femoral bone plate during the period of November 2009 to December 2011 in our hospital was performed via analyzing type of fracture,bone quality and quality of fracture reduction.Results Nine cases failed after surgery,including breakage of plate in 6 cases,pullout of screw in 1 case,cutting-out of screw in 2 cases.The failure rate was 13.64%.The pattern of the fractures included Evans Ⅲ type in 2 cases,Ⅳ type in 4 cases and Ⅴ type in 3 cases.The quality of the bone was rated by the Singh index: grade Ⅴ in 1 case,grade Ⅳ in 2 cases,grade Ⅲ in 2 cases and grade Ⅱ in 4 cases.Conclusion The major causes for internal fixation failure using locking proximal femoral bone plate seem to be incorrect selection of the case,nonanatomically reduction of fractures,and poor bone quality.The keys of operation are correct surgical indications and meticulous surgical technique.更多还原