摘要
目的探讨Gamma钉技术治疗股骨转子间骨折并发症的发生因素。方法1998年1月～2004年5月收治50例股骨转子间骨折患者，男18例，女32例；年龄47～82岁。左侧16例，右侧34例。Evans分型：Ⅰ型4例，Ⅰ型2例，Ⅰ型23例，Ⅳ型10例，Ⅴ型11例。均采用Gamma钉技术手术治疗。结果术后50例获随访4～29个月。35例负重行走有力，髋关节活动达到正常范围，按Harris评分标准：优30例，良5例；15例出现并发症：髋内外翻5例，拉力螺钉切出及下肢短缩2例，下肢外旋畸形3例，髋关节痛2例，膝关节痛并僵直1例，股骨锁钉处骨折1例，内固定失败1例。结论造成并发症的原因是多方面的，主要在于手术时机延迟导致手术难度增加；对骨折类型了解分析不充分；手术操作不规范；手术器材了解不完全；术后忽视康复指导和功能锻炼不当及过早负重所致。
Objective To analyse the factors of complications after treatment of intertrochanteric fractures with Gamma nail. Methods From January 1998 to May 2004, 50 patients were treated with Gamma nail, including 18 males and 32 females and ageing from 47 to 82 years. The locations were the left side in 16 cases and the right in 34 cases. According to Evans classification, there were 4 cases of type Ⅰ, 2 cases of type Ⅰ, 23 cases of type Ⅰ , 10 cases of type Ⅳ and 11 cases of type Ⅴ. Results Fifty patients were followed up 4-29 months. According to the Harris criterion for evaluation, the results were excellent and good in 35 cases, showing sthenic weight loading walking and normal range of motion of the hip joint. The postoperative complications appeared in 15 cases： 5 cases of coxa vara or coxa valga, 3 cases of rotation deformity of lower limb, 2 cases of tension screw protrusions and lower shorten, 1 case of failure of internal fixation, 1 case of femoral fracture, 2 cases of coxalgia and 1 case of pain in knee joint and stiff knee joint. Conclusion The reason of complications was various, mainly lies in insufficient comprehension and analysis of the types of fractures, unfamiliarity with the characteristics and usage of the instruments and neglected rehabilitation instruction, inappropriate functional training and too early weight loading after operation.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2007年第1期9-11,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
GAMMA钉
股骨
转子间骨折
并发症
Gamma nail Femur Intertrochanteric fractures Complications
作者简介
通讯作者：曾宪林，副主任医师，研究方向：关节和创伤外科，E—mail：apolozx1@yahoo．com．cn.
