【摘要】 目的:探讨DHS治疗股骨转子间骨折发生螺钉切割股骨头并发症的原因。方法:2006年6月～2010年6月收治的股骨转子间骨折122例,行DHS内固定手术治疗。分析术后发生螺钉切割股骨头的原因。运用Harris评分评价髋关节功能恢复情况。结果:122例患者平均随访18个月(12～30月),术后髋关节Harris评分:良98例,中18例,差6例,其中优良率为95.1%。10例患者在术后1年内出现不同程度股骨颈螺钉切割股骨头,合并髋内翻畸形,其中行植骨手术2例,2例未处理,2例更换DHS内固定,同时原钉道自体植骨治疗,4例行人工关节置换术。结论:股骨转子间骨折行DHS钢板内固定要求良好的复位和固定;发生股骨颈螺钉切割股骨头与骨折粉碎程度、复位质量、螺钉放置位置,及股骨颈骨质质量等多种因素相关。更多还原

【Abstract】 Objective:To analyze cause for postoperative femeral neck nail cutting-out after treatment of femeral intertrochanteric fractures with DHS plate(DHS).Methods:An retrospective study was done on 122 patients with intertrochanteric fractures treated with DHS plate from June 2006 to June 2010.The cause for postoperative femeral neck nail cutting-out were analyzed.Harris score was used to evaluate the functional recovery of the hip joint.Results:Of all,122 patients were followed up for 12-30 month(smean 22 months).According to Harris evaluation system,the results were excellent and good in 98 patients,fair in 18 and poor in 6.Postoperative femeral neck nail cutting-out in 10 patients,two of whom received reoperration to translate bone,two of whom received reopertion to fix with DHS plate and to translate bone;two of them received clinical observation whitout receiving reoperation,and other four patients received prosthetic replacement.Conclusion:Treatment of femeral intertrochanteric fractures with DHS plate requires good reduction and fixation of the fractures.Many factors including cortical bone conditions of little trochanter,postoperative patients cognitive condition,use of improved Iensen-Evans classification and Singh’s classification may affect operation outcome.更多还原