CAJ | 학술논문

目的：分析动力髋（DHS）内固定致股骨头切出的原因及预防措施。方法总结自2000年~2011年应用动力髋固定195例股骨转子间骨折的治疗经验，对19例动力髋螺钉切出股骨头失败病例进行分类及分析。结果195例患者均获得3~22个月（平均16个月）随访，19例发生切出股骨头（9.74%）。分析失败病例，其中尖顶距（TAD）值＞25 mm 9例。A1型1例，A2型4例，A3型14例。动力髋螺钉位置于股骨颈中心者7例，偏离中心者12例。结论“TAD”值过大、骨质疏松患者术后过早活动、内固定选择不合适、术中操作不当是动力髋螺钉切出的重要因素。
목적：분석동력관（DHS）내고정치고골두절출적원인급예방조시。방법총결자2000년~2011년응용동력관고정195례고골전자간골절적치료경험，대19례동력관라정절출고골두실패병례진행분류급분석。결과195례환자균획득3~22개월（평균16개월）수방，19례발생절출고골두（9.74%）。분석실패병례，기중첨정거（TAD）치＞25 mm 9례。A1형1례，A2형4례，A3형14례。동력관라정위치우고골경중심자7례，편리중심자12례。결론“TAD”치과대、골질소송환자술후과조활동、내고정선택불합괄、술중조작불당시동력관라정절출적중요인소。
ObjectiveTo analyse the reason of cut-out from femoral head about DHS and provide theoretical basis for clinical appilation of DHS.Methods The 195 cases treatment experiences were summarized with DHS method from 2000 to 2011. The classification of femoral head resection was analyzed. Results The duration of the follow-up ranged from 3 to 22 months( 16 months on average). There were 19 cases with the cut-out of the lag screw from the femoral head following internal fixation(9.74%). Analysis of failure cases, the tip apex distance (TAD) value exceed 25mm in 9 cases. Type A1 1 cases, type A2 4 cases, type A3 14 cases. The screw position display screw position in the femoral neck center in 7 cases, 12 cases of deviation from the center. Conclusions The greater the“TAD”value,the osteoporosis in patients with postoperative early activities, internal fixation selection is inappropriate, improper operation is an important factor of dynamic hip screw cut out.