摘要
目的探讨应用倒置微创内固定系统（1essinvasivestabilizationsystem，HSS）钢板治疗股骨转子间骨折的临床疗效。方法纳入2007年1月—2011年1月应用倒置LISS钢板内固定治疗的股骨转子间骨折患者22例，其中男12例，女10例；年龄44～86岁，平均72．5岁。左侧8例，右侧14例。致伤原因：平地跌伤15例，交通伤4例，高处坠落伤3例。骨折根据按Evans—Jensen分型：Ⅲ型13例，Ⅳ型9例。均为闭合性骨折。受伤至手术时间3—14d，平均5．3d。结果术中出血（131±60）ml，手术时间（55±15）min。22例患者均获随访12～30个月，平均14．8个月。骨折愈合时间10～27周，平均13．4周。髋关节功能恢复程度参照Harris评分：优11例，良8例，可2例，差1例，优良率为86％。随访期间2例感大转子部位疼痛不适，1例术后6个月检查示骨折部位钢板断裂，骨折畸形愈合，不需要进一步治疗。余19例无手术部位感染、髋内翻、内固定折断及骨折再移位、无螺钉拔出或切出等并发症。结论倒置LISS钢板治疗股骨转子间骨折临床疗效满意，但仍存在一定的失败率。
Objective To evaluate the clinic effect of reverse less invasive stabilization system （LISS） in treatment of femoral intertrochanteric fracture. Methods The study enrolled 22 cases of femoral intertrochauteric fractures treated with reverse LISS from January 2007 to January 2011. Twelve out of the cases were males and 10 were females, with age ranging from 44 to 86 years （mean, 72.5 years）. Left fracture occurred in 8 cases and right in 14 cases. Causes of injury included fall on the ground in 15 cases, vehicle accidents in 4 cases, and fall from height in 3 cases. There were 15 cases of type 1/1 and 9 of type 1V according to Evans-Jensen classification and all fractures were closed injuries. Time from injury to operation was 3-14 days （mean, 5.3 days）. Results Intraoperative hemorrhage was （ 130.5 ± 60 ） ml and operation time was （ 55 ± 15 ） min. All cases were followed up for 12- 30 months （mean, 14.8 months）. Fracture healing time was 10-27 weeks （mean, 13.4 weeks）. Harris hip score was excellent in 11 cases, good in 8, fair in 2, and poor in 1, with excellent and good rate of 86%. Two eases felt greater trochanter pain at follow-up ; one presented with plate breakage and malunion at 6 months postoperatively, but may need no further treatment; the rest healed without complications of surgical site infection, varus deformity of the hip, implant breakage, fracture redisplacement, screw draw- ing pullout or cutout. Conclusion Reverse LISS plating is an effective treatment for femoral intertro- chanteric fractures, but the procedure can not assure 100% success.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2014年第5期428-432,共5页
Chinese Journal of Trauma
基金
义乌市科技计划资助项目（11-3-03）
温州医科大学重大科技专项资助项目（QTJ06012）
关键词
股骨骨折
骨折固定术
内
外科手术
微创性
Femoral fractures
Fracture fixation,internal
Surgical procedures, minimally invasive
