CAJ | 학술논문

目的：探讨有限切开Intertan内固定治疗粉碎性股骨转子下骨折的手术技巧和临床疗效。方法回顾性分析2008年9月～2011年7月收治37例粉碎性股骨转子下资料，男性26例，女性11例；年龄27～63岁，平均42.3岁。按股骨转子下骨折的Seinsheimer分类：ⅢA型8例，ⅢB型17例，Ⅳ型12例。均采用有限切开复位Intertan内固定治疗，评估术中出血情况及术后患者功能恢复情况。结果本组平均手术时间73min（45～110min），平均术中出血量130ml（60～230ml）。本组病例均得到随访，平均13个月（9～21个月）。平均骨折愈合时间4.3个月（3～6.9个月）。深部感染1例。参照Sanders等推荐的创伤性髋关节等级评分：优16例，良13例，可6例，差2例，优良率78.4％。结论采用有限切开Intertan内固定治疗粉碎性股骨转子下骨折，并发症少、疗效好，正确掌握手术技巧，可取得较好效果。
목적：탐토유한절개Intertan내고정치료분쇄성고골전자하골절적수술기교화림상료효。방법회고성분석2008년9월～2011년7월수치37례분쇄성고골전자하자료，남성26례，녀성11례；년령27～63세，평균42.3세。안고골전자하골절적Seinsheimer분류：ⅢA형8례，ⅢB형17례，Ⅳ형12례。균채용유한절개복위Intertan내고정치료，평고술중출혈정황급술후환자공능회복정황。결과본조평균수술시간73min（45～110min），평균술중출혈량130ml（60～230ml）。본조병례균득도수방，평균13개월（9～21개월）。평균골절유합시간4.3개월（3～6.9개월）。심부감염1례。삼조Sanders등추천적창상성관관절등급평분：우16례，량13례，가6례，차2례，우량솔78.4％。결론채용유한절개Intertan내고정치료분쇄성고골전자하골절，병발증소、료효호，정학장악수술기교，가취득교호효과。
Objective To investigate the clinical efficacy and discuss the surgical techniques of minimal invasive surgery using Intertan device for the treatment of comminuted subtrochanteric fractures .Methods A total of 37 comminuted subtrochanteric fractures patients were analyzed retrospectively from Sept .2008 to Jul.2011. There were 26 males and 11 females,with a mean age of 42.3 years (27 to 63 years).According to the Seinsheimer classification of subtrochanteric fractures ,8 cases were of type ⅢA,17 cases of type ⅢB,and 12 cases of type Ⅳ. All the patients were treated with limited open reduction and internal fixation of Intertan .Intra-operative blood loss was measured and postoperative functional outcomes were evaluated at follow -ups.Results The mean operation time was 73 minutes(45 to 110 minutes),and the mean intra-operative blood loss was 130ml(60 to 230ml).All the patients obtained an average follow-up of 13 months (9 to 21 months).The average fractures healing time was 4.3 months (3 to 6.9 months),and there was 1 case of deep infection.In accordance with the traumatic hip score recommended by Sanders,there was excellent in 16 cases,good in 13 cases,fair in 6 cases,poor in 2 cases,and the satisfactory rate was 78.4%.Conclusion Good outcomes of comminuted subtrochanteric fractures are expectable under minimal invasive surgery using Intertan nail ,and a lower rate of complications is achievable with proper surgi-cal techniques applied.