HOW TO MINIMIZE FAILURES OF FIXATION OF UNSTABLE INTERTROCHANTERIC FRACTURES
HOW TO MINIMIZE FAILURES OF FIXATION OF UNSTABLE INTERTROCHANTERIC FRACTURES
复制标题
DOI：
10.1016/0020-1383(95)00125-s
复制
发表时间：
1995-11-01
影响因子：
2.5
通讯作者：
SIMPSON, AHRW
中科院分区：
文献类型：
--
作者：
GUNDLE, R;GARGAN, MF;SIMPSON, AHRW
滑动髋螺钉改善了不稳定性股骨转子间骨折的治疗，与固定器械相比，其成功在很大程度上是由于植入物和骨折碎片之间的载荷分担。在对100例此类骨折患者的前瞻性研究中，研究了与骨折及其固定有关的五个因素，并计算了其在预测失败中的相对重要性的比值比。影响骨折块承受载荷的最重要因素是器械内可用的滑动量，影响器械承受载荷的因素是螺钉在股骨头中的位置。对于使用允许滑动小于10 mm的器械固定的骨折，以及使用上级螺钉位置的骨折，失效风险分别增加了3.2和5.9倍。在三项前瞻性随机试验中，对于这些骨折，建议单独进行解剖复位，而不是截骨术，同时进行滑动髋螺钉固定。如果在这里计算，以允许足够的滑动时，采用这种技术，这是必不可少的，我们一个短桶装置时，翼动态螺钉85毫米或更少。这还没有证明之前。
Sliding hip screws have improved the treatment of unstable intertrochanteric hip fractures and their success, compared with fixed devices, is in large part due to the sharing of load between the implant and the fracture fragments. In a prospective study of 100 patients with such fractures, five factors concerned with the fracture and its fixation were studied and odds ratios calculated of their relative importance in prediction of failure. The most important factor affecting the load borne by the fracture fragments was the amount of slide available within the device, and that affecting the load carried by the device was the position of the screw in the femoral head. For fractures fixed with a device allowing less than 10 mm of slide, and those with superior screw position, the risk of failure was increased by factors of 3.2 and 5.9, respectively. Anatomical reduction alone, rather than osteotomy, together with sliding hip screw fixation, has been recommended for these fractures in three prospective randomized trials. If is calculated here that to allow sufficient slide when employing this technique, it is essential to we a short barrel device when wing dynamic screws of 85 mm or less. This has not been demonstrated before.