锁定钢板桥接固定治疗股骨粗隆下SeinsheimerⅤ型骨折
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作者Author单位AddressE-Mail
刘印文 LIU Yin-wen 上海中医药大学附属曙光医院骨伤科, 上海 201203 Department of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai TCM University, Shanghai 201203, China  
郑昱新 ZHENG Yu-xin 上海中医药大学附属曙光医院骨伤科, 上海 201203 Department of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai TCM University, Shanghai 201203, China  
沈孜良 SHEN Zi-liang 上海中医药大学附属曙光医院骨伤科, 上海 201203 Department of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai TCM University, Shanghai 201203, China  
王树强 WANG Shu-qiang 上海中医药大学附属曙光医院骨伤科, 上海 201203 Department of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai TCM University, Shanghai 201203, China  
卫晓恩 WEI Xiao-en 上海中医药大学附属曙光医院骨伤科, 上海 201203 Department of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai TCM University, Shanghai 201203, China  
张磊 ZHANG Lei 上海中医药大学附属曙光医院骨伤科, 上海 201203 Department of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai TCM University, Shanghai 201203, China  
顾新丰 GU Xin-feng 上海中医药大学附属曙光医院骨伤科, 上海 201203 Department of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai TCM University, Shanghai 201203, China  
匡勇 KUANG Yong 上海中医药大学附属曙光医院骨伤科, 上海 201203 Department of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai TCM University, Shanghai 201203, China  
詹红生 ZHAN Hong-sheng 上海中医药大学附属曙光医院骨伤科, 上海 201203 Department of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai TCM University, Shanghai 201203, China shgsyjs@139.com 
石印玉 SHI Yin-yu 上海中医药大学附属曙光医院骨伤科, 上海 201203 Department of Orthopaedics and Traumatology, Shuguang Hospital Affiliated to Shanghai TCM University, Shanghai 201203, China  
期刊信息:《中国骨伤》2016年,第29卷,第1期,第68-72页
DOI:10.3969/j.issn.1003-0034.2016.01.015
基金项目:“中医骨伤科学”国家重点学科(编号:100508);上海市中医药领军人才建设项目(编号:2012-63-15);上海领军人才项目(编号:041);“海派中医流派传承研究基地” (编号:ZYSNXD-CC-HPGC-JD-001,ZY3-CCCX-1-1003);上海市卫生和计划生育委员会中医药科研基金(编号:2014LP096A);上海市进一步加快中医药事业发展三年行动计划项目(编号:ZY3-CCCX-3-3004)
中文摘要:

目的:探讨应用锁定钢板桥接固定治疗股骨粗隆下Seinsheimer V型骨折的临床价值。

方法:2009年3月至2014年9月,采用切开复位、锁定钢板桥接固定治疗18例股骨粗隆下Seinsheimer V型骨折,男16例,女2 例;年龄22~67岁,平均41岁。车祸伤12例,高处坠落伤5例,重物砸伤1例;均为闭合性新鲜骨折,伤后至手术时间4~9 d,平均6.2 d.11例使用股骨髁锁定钢板倒置内固定,7例使用股骨近端锁定解剖钢板内固定。

结果:18例患者手术时间90~155 min,平均110 min;术中出血量350~650 ml,平均425 ml.术中或术后输血共16例,平均输血量300 ml.住院天数为12~18 d,平均14 d.全部病例获得随访,时间8~22个月,平均11.8个月;骨折愈合时间为5~8个月,平均6.6个月。术后未发生感染、内固定失败、髋内翻、下肢外旋畸形、脂肪栓塞等并发症。末次随访Sanders髋关节功能评分平均53.22±6.48,其中优12例,良6例。

结论:在坚持生物学固定的前提下,锁定钢板桥接固定治疗股骨粗隆下SeinsheimerV型骨折,具有力学强度高、血供干扰少、并发症少、骨愈合率高、安全可靠的优点,是治疗该类型骨折较为理想的选择。
【关键词】股骨骨折  髋骨折  骨折固定术,内  外科手术
 
Bridging fixation with locking plate for the treatment of subtrochanteric femoral fractures of Seinsheimer type Ⅴ
ABSTRACT  

Objective:To investigate the clinical effect of bridging fixation with locking plate for the Seinsheimer type V subtrochanteric femoral fracture.

Methods:From March 2009 to September 2014,18 cases of Seinsheimer type V subtrochanteric femoral fracture were treated by open reduction and bridging fixation with locking plate through proximal and distal approach including 16 males and 2 females with an average age of 41 years old ranging from 22 to 67 years old. Among them,12 cases caused by traffic accident,5 cases by falling,1 case by heavy aboving. All cases were fresh and closed fractures. Time between injury and operation was from 4 to 9 days with an average of 6.2 days. Of them,11 cases were fixed with reverse LISS and the other 7 cases were fixed with anatomical locking plates of proximal femur.

Results:The mean time of operation was 110 min (ranged from 90 to 155 min). The mean blood loss during operation was 425 ml (ranged from 350 to 650 ml) and 16 cases got blood transfusion which was meanly 300 ml. The mean hospital time was 14 days (ranged from 12 to 18 days). The mean duration of followed up was 11.8 months (ranged from 8 to 22 months). The mean time of bone union was 6.6 months (ranged from 5 to 8 months). There was not any complication such as infection,implant failure,hip varus,external rotation deformity of low limb or fat embolism. The Sanders hip scores were 53.22±6.48,the result was excellent in 12 cases and good in 6 cases at the last follow-up.

Conclusion:Under the principle of biological osteosynthesis,treatment of Seinsheimer type V subtrochanteric femoral fracture with bridging locking plate fixation has such advantages as high mechanism,less interference of blood supply,stable fixation and little complication. It is a safe and idea way for the treatment of the Seinsheimer type V subtrochanteric femoral fracture.
KEY WORDS  Femural fractures  Hip fractures  Fracture fixation,internal  Surgical procedures,operative
 
引用本文,请按以下格式著录参考文献:
中文格式:刘印文,郑昱新,沈孜良,王树强,卫晓恩,张磊,顾新丰,匡勇,詹红生,石印玉.锁定钢板桥接固定治疗股骨粗隆下SeinsheimerⅤ型骨折[J].中国骨伤,2016,29(1):68~72
英文格式:LIU Yin-wen,ZHENG Yu-xin,SHEN Zi-liang,WANG Shu-qiang,WEI Xiao-en,ZHANG Lei,GU Xin-feng,KUANG Yong,ZHAN Hong-sheng,SHI Yin-yu.Bridging fixation with locking plate for the treatment of subtrochanteric femoral fractures of Seinsheimer type Ⅴ[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(1):68~72
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