股骨转子间骨折治疗方法的研究
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作者Author单位AddressE-Mail
吴有鲁 WU You-lu 杭州市余杭第二人民医院骨科, 浙江杭州311121 Yuhang the Second Peoples Hospital of Hangzhou WYL660606@Tom.com 
张勤中 ZHANG Qin-zhong 杭州市余杭第二人民医院骨科, 浙江杭州311121 Yuhang the Second Peoples Hospital of Hangzhou  
冯庆生 FENG Qing-sheng 杭州市余杭第二人民医院骨科, 浙江杭州311121 Yuhang the Second Peoples Hospital of Hangzhou  
章武华 ZHANG Wu-hua 杭州市余杭第二人民医院骨科, 浙江杭州311121 Yuhang the Second Peoples Hospital of Hangzhou  
丁彩田 DING Cai-tian 杭州市余杭第二人民医院骨科, 浙江杭州311121 Yuhang the Second Peoples Hospital of Hangzhou  
费爽明 FEI Shuang-ming 杭州市余杭第二人民医院骨科, 浙江杭州311121 Yuhang the Second Peoples Hospital of Hangzhou  
闻鑫高 WEN Xin-gao 杭州市余杭第二人民医院骨科, 浙江杭州311121 Yuhang the Second Peoples Hospital of Hangzhou  
林栋 LIN Dong 杭州市余杭第二人民医院骨科, 浙江杭州311121 Yuhang the Second Peoples Hospital of Hangzhou  
期刊信息:《中国骨伤》2004年,第17卷,第4期,第215-217页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz
基金项目:
中文摘要:

目的:比较多种治疗股骨转子间骨折方法各自的优缺点及最佳适应证,从而找出一种最佳的治疗方案。

方法:从1991-2001年共收治病例140例,采用瑞士动力髋螺钉(Richard钉)、单臂外固定支架、麦氏鹅头钉、AO角度钢板内固定治疗及骨牵引保守治疗股骨转子间骨折,从中分析出治疗效果的优劣及并发症发生率的多少。

结果:Richard钉固定最稳定,承载最大,治疗优良率最高,发生的并发症最少;其次是外固定支架,角度钢板及麦氏鹅头钉。

结论:保守牵引治疗股骨转子间骨折经济、安全、简单,但长期卧床易导致并发症且易发生髋内翻,治疗优良率低。对于采用内固定治疗的患者,应首选动力髋螺钉。对于不能忍耐较大手术的患者,应尽可能应用单臂外固定支架。少数用Richard钉及多功能支架难于固定的患者,可采用AO角度钢板固定。而麦氏鹅头钉因其结构不够合理,固定强度不足,术后并发症多,应放弃使用。
【关键词】股骨转子间骨折  骨折固定术  牵引术
 
Study of therapeutic method for intertrochanteric fracture
ABSTRACT  

Objective: To compare therapeutic methods of intertrochanteric fracture and their merits,defects and indication,in order to find out a best clinical protocol for intertrochanteric fracture.

Methods: From 1991 to 2001,140 cases of intertrochanteric fracture were treated with Richard nail,lateral external fixation,goose-head shape nail,AO angle steel plate and skeletal traction;effect and incidence of complication in the therapeutic methods were analyzed respectively.

Results: Richard nail was the most stable,with maximum bear weight,highest good therapeutic efficacy rate and least complication incidence.The second was lateral external fixation and then AO angle steel plate and goose-head shape nail with the poorest therapeutic efficacy.

Conclusion: According to our study,conservative traction therapy is an economic,safe and simple method for the treatment of intertrochanteric fracture.However,long-term bed cause more complication and coax-inversion,with poor therapeutic efficacy.The internal fixation,Richard nail will be the first choice for those patients.The lateral external fixation should be used as long as possible for the patients who cannot tolerate a big operation.While AO angle steel plate can also be used for those difficult to be fixed by Richard nail or lateral external fixation.Goose-head shape nail should be given up to use since its irrational structure and insufficient fixation strength but high complication.
KEY WORDS  Intertrochanteric fracture  Fracture fixation  Traction
 
引用本文,请按以下格式著录参考文献:
中文格式:吴有鲁,张勤中,冯庆生,章武华,丁彩田,费爽明,闻鑫高,林栋.股骨转子间骨折治疗方法的研究[J].中国骨伤,2004,17(4):215~217
英文格式:WU You-lu,ZHANG Qin-zhong,FENG Qing-sheng,ZHANG Wu-hua,DING Cai-tian,FEI Shuang-ming,WEN Xin-gao,LIN Dong.Study of therapeutic method for intertrochanteric fracture[J].zhongguo gu shang / China J Orthop Trauma ,2004,17(4):215~217
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