Fixation of subtrochanteric fractures : Does a technical optimization of the dynamic hip screw application improve the results?
Fixation of subtrochanteric fractures : Does a technical optimization of the dynamic hip screw application improve the results?
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DOI：
10.1007/s11751-009-0058-z
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发表时间：
2009-10
影响因子：
0.8
通讯作者：
Massoud EI
中科院分区：
文献类型：
--
作者：
Massoud EI
转子下区域具有某些解剖学和生物力学特征，这可能使外科医生难以治疗该区域的骨折。首选的设备类型是一个争论的问题。对动力髋螺钉（DHS）力学特性的了解增加，降低了并发症的发生率。我们的假设是基于DHS应用程序的技术优化。我们前瞻性研究了37例平均年龄为42.9岁的股骨转子下骨折患者。我们采用了两阶段方案：首先，粉碎性骨折转化为两部分骨折;然后使用允许DHS动力化的技术应用植入物。使用临床和影像学数据评估12个月时的结局。骨折愈合时间平均11.64周。1例患者患肢短缩1.5 cm。未报告植入物失效。所有患者均恢复了伤前的日常生活活动。得出的结论是，接受DHS应用技术优化治疗的患者在术后实现了接近正常的解剖结构，并在整个随访期间保持这种状态。
The subtrochanteric region has certain anatomical and biomechanical features that can make fractures in this region difficult for the treating surgeon. The preferred type of device is a matter of debate. Increased understanding of mechanical characteristics of the dynamic hip screw (DHS) has reduced the incidence of complications. Our hypothesis is based on the technical optimization of the DHS application. We prospectively studied 37 patients with subtrochanteric fractures with a mean age of 42.9 years. We utilized a two-stage protocol: initially, conversion of the comminuted fractures into two part fractures; then application of the implant with a technique that allowed dynamization of the DHS. Clinical and radiographic data were used to assess the outcome at 12 months. Fracture healing was obtained for all cases in a mean time of 11.64 weeks. One patient had 1.5 cm shortening of the injured limb. No implant failure was reported. All patients resumed pre-injury activities of daily living. It was concluded that the patients who were treated with the technical optimization of the DHS application achieved a close-to-normal anatomy following surgery and maintained this state throughout the follow-up period.