CAJ | 학술논문

目的探讨应用倒置微创内固定系统(less invasive stabilization system,LISS)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.
목적 탐토응용도치미창내고정계통(less invasive stabilization system,LISS)강판치료고골전자간골절적림상료효. 방법 납입2007년1월-2011년1월응용도치LISS강판내고정치료적고골전자간골절환자22례,기중남12례,녀10례;년령44 ～86세,평균72.5세.좌측8례,우측14례.치상원인:평지질상15례,교통상4례,고처추락상3례.골절근거안Evans-Jensen분형:Ⅲ형13례,Ⅳ형9례.균위폐합성골절.수상지수술시간3～14d,평균5.3d. 결과 술중출혈(131 ±60) ml,수술시간(55 ±15) min.22례환자균획수방12～ 30개월,평균14.8개월.골절유합시간10 ～27주,평균13.4주.관관절공능회복정도삼조Harris평분:우11례,량8례,가2례,차1례,우량솔위86％.수방기간2례감대전자부위동통불괄,1례술후6개월검사시골절부위강판단렬,골절기형유합,불수요진일보치료.여19례무수술부위감염、관내번、내고정절단급골절재이위、무라정발출혹절출등병발증. 결론 도치LISS강판치료고골전자간골절림상료효만의,단잉존재일정적실패솔.
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 intertrochanteric 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 Ⅲ and 9 of type Ⅳ 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 cases 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 drawing pullout or cutout.Conclusion Reverse LISS plating is an effective treatment for femoral intertrochanteric fractures,but the procedure can not assure 100％ success.