中国保健营养（中旬刊）
中國保健營養（中旬刊）
중국보건영양（중순간）
China Hwalth Care & nutrition
2013年
5期
750-751
,共2页
目的：探讨DHS系统置入质量控制提高DHS置入准确性。方法：选择2009年3月至2012年3月，采用DHS系统内固定31例，Evans分型，I型：17例，II型14例。多学科对患者原有基础疾病进行明确诊断，专科治疗，基础疾病控制平稳，健康状况明显改善后，尽早手术。术前股骨髁上骨牵引复位，完全纠正短缩、旋转畸形，颈干角与对侧相似，并适当“过牵”。将DHS系统置入：主钉距离股骨头边缘5－10mm，透视正侧位在股骨颈内中置，侧钢板位于股骨近端外侧中线，贴合良好的标准位置。结果：23例符合DHS内固定者，置入标准位置，4例主钉选择偏短，DHS主钉距离股骨头边缘＞10mm以上，其中，3例在股骨颈正侧位，主钉未能中置，选择较短主钉。1例置入偏短主钉。2例DHS侧钢板由于进钉点偏前，侧钢板未置入股骨近端外侧中线。1例术后主钉从股骨颈切出，术后8天进行翻修手术。30例术后1、3、6、12月门诊骨盆正位，股骨颈正轴位正示，获得骨性愈合，无主钉断钉，断板,1例主钉切出。结论：导针、主钉置入质量控制，是DHS系统置入质量控制的关键。
目的：探討DHS繫統置入質量控製提高DHS置入準確性。方法：選擇2009年3月至2012年3月，採用DHS繫統內固定31例，Evans分型，I型：17例，II型14例。多學科對患者原有基礎疾病進行明確診斷，專科治療，基礎疾病控製平穩，健康狀況明顯改善後，儘早手術。術前股骨髁上骨牽引複位，完全糾正短縮、鏇轉畸形，頸榦角與對側相似，併適噹“過牽”。將DHS繫統置入：主釘距離股骨頭邊緣5－10mm，透視正側位在股骨頸內中置，側鋼闆位于股骨近耑外側中線，貼閤良好的標準位置。結果：23例符閤DHS內固定者，置入標準位置，4例主釘選擇偏短，DHS主釘距離股骨頭邊緣＞10mm以上，其中，3例在股骨頸正側位，主釘未能中置，選擇較短主釘。1例置入偏短主釘。2例DHS側鋼闆由于進釘點偏前，側鋼闆未置入股骨近耑外側中線。1例術後主釘從股骨頸切齣，術後8天進行翻脩手術。30例術後1、3、6、12月門診骨盆正位，股骨頸正軸位正示，穫得骨性愈閤，無主釘斷釘，斷闆,1例主釘切齣。結論：導針、主釘置入質量控製，是DHS繫統置入質量控製的關鍵。
목적：탐토DHS계통치입질량공제제고DHS치입준학성。방법：선택2009년3월지2012년3월，채용DHS계통내고정31례，Evans분형，I형：17례，II형14례。다학과대환자원유기출질병진행명학진단，전과치료，기출질병공제평은，건강상황명현개선후，진조수술。술전고골과상골견인복위，완전규정단축、선전기형，경간각여대측상사，병괄당“과견”。장DHS계통치입：주정거리고골두변연5－10mm，투시정측위재고골경내중치，측강판위우고골근단외측중선，첩합량호적표준위치。결과：23례부합DHS내고정자，치입표준위치，4례주정선택편단，DHS주정거리고골두변연＞10mm이상，기중，3례재고골경정측위，주정미능중치，선택교단주정。1례치입편단주정。2례DHS측강판유우진정점편전，측강판미치입고골근단외측중선。1례술후주정종고골경절출，술후8천진행번수수술。30례술후1、3、6、12월문진골분정위，고골경정축위정시，획득골성유합，무주정단정，단판,1례주정절출。결론：도침、주정치입질량공제，시DHS계통치입질량공제적관건。
Objective:To investigate the quality control in the DHS placement to improve the accuracy of the DHS placement. Methods:From March 2009 to March 2012, 31 cases were fixed with the DHS systems, according Evans classification, type I:17 cases, and 14 cases of Type II. The patients were operated as soon as possible after treated against the original diseases. The femoral epicondylus tractions were performed preoperatively to correct the shortening and rotational deformity completely and to make the neck shaft angle similar to the contralateral and to keep appropriate over-traction stations. The DHS systems were placed:the main nail was placed about 5-10mm from the head edge of femoral and were sure in the middle of the neck of the femoral with fluoroscopy, and the plate was placed in the standard position on the middle line of the proximal of the femoral. Result:The nails were in the standard position in 23 cases, and were too short in 4 cases with the distance over 10mm from the edge of the head of the femoral. The nails were not in the standard position and too short in 3 cases, and was too short in 1 case. The plates of DHS were not on the middle line of the proximal of the femoral because the start points were in the front of the standard point. The nail was out of the neck of the femoral post operation, and had to revision after 8 days post operation. 30 cases of fractures were union without broken of the nails and plate with fol owed 12 months, and the nail was out of the neck of the femoral. Conclusion:The quality control in the nail placement with the guide needle is the key point to the quality control in the DHS system placement.
