IR@PKUHSC  > 北京大学第三临床医学院  > 骨科
学科主题骨科学
反向微创内固定系统治疗特殊类型股骨近端骨折
其他题名Treatment of special proximal femoral fractures with less invasive stabilization system
张志山; 周方; 田耘; 姬洪全
关键词股骨骨折 骨折固定术 微创内固定系统 Femoral Fractures Less Invasive Stabilizationsystem Fracture Fixation Intramedullary
刊名中华创伤杂志
2009
DOI10.3760/cma.j.issn.1001-8050.2009.01.16
25期:1页:48-52
收录类别中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型Journal Article
摘要目的 分析反向采用微创内固定系统(less invagive stabilization system,LISS)治疗特殊类型股骨近端骨折的手术技术并总结临床治疗效果.方法 自2005年6月至2007年12月,反向应用LISS治疗特殊的股骨近端骨折28例.所有患者均不能经闭合牵引获得复位.转子间骨折8例,采用AO分类法:31 A2.2型3例,31 A2.3型2例,31 A3.1型1例,31 A3.3型2例;转子下骨折19例,采用Seinsheimer分型:ⅡA型3例,ⅢB型1例,Ⅴ型15例;股骨假体周围骨折1例(Vancouver B1型).记录手术时间、术中出血量、术后并发症、骨折愈合时间和术后髋功能评分.结果 手术时间45~120 min,平均88 min;出血量50~700 ml,平均320 ml.术后下肢深静脉血栓2例、心肌梗死发作1例、下消化道出血1例,未出现切口感染.1例乳腺癌患者术后脑转移症状加重死亡,3例失访.24例获得6~33个月、平均18个月随访.1例Seinsheimer V型患者转子下骨折不愈合,术后6个月近端螺钉断裂;其余23例骨折愈合时间2~5个月,平均3个月.Harris评分70~99分,平均84分.结论 反向股骨LISS治疗特殊类型的股骨近端骨折,具有创伤小、操作简便、固定可靠、安全性高、并发症少的特点.熟练掌握复位技术,正确放置A孔导针,避免过早负重是手术成功的关键. Objective To discuss the indications, surgical techniques and outcome of less invasive stabilization system (LISS) in treatment of special proximal femoral fractures. Methods Twenty-eight patients with special proximal femoral fractures were treated with LISS from June 2005 to December 2007. All fractures could not be reduced by close reduction with traction table. There were eight patients with in-tertrochanterie fractures ( including type 31-A2.2 fractures in three, type 31-A2.3 in two, type 31-A3.1 in three and type 31-A3.3 in two according to AO classification), 19 with subtrochanteric fractures (including type ⅡA fractures in three, type ⅢB in one and type Ⅴ in 15 according to Seinsheimer classification) and one with peripheral fractures ( type Vancouver B1 fracture) of the femoral prosthesis. The data about opera-tion duration, intraoperative blood loss, postoperative complications, fracture healing time and postoperative hip function score were recorded. Results The operation lasted for mean 88 minutes (45-120 minutes), with intra-operative blood loss of average 320 ml (50 -700 ml). There occurred deep vein thrombosis of lower limb in two patients, myocardial infarction in one and lower digestive tract bleeding in one after oper-ation, with no incision complications. One patient with breast cancer was died of brain metastasis after op-eration and three lost follow-up. Other 24 patients were followed up for mean 18 months (6-33 months), which showed that 23 patients got fracture healing 2-5 months ( average 3 months) postoperatively but that one patient with type Seinsheimer V fracture had breakage of proximal locking screws six months postopera-tively because of nonunion of subtrochanteric fracture. The Harris score of the hip was 70-99 points ( aver-age 84 points). Conclusions Reverse femoral LISS has advantages of minimal invasion, easy opera-tion, stable fixation, high degree of safety and minor complications for treatment of special proximal femoral fractures. Skillful reduction, correct positioning of guide wire into hole A and avoidance of immediate weight bearing are key to success of the operation.
语种中文
原文出处查看原文
引用统计
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/70709
专题北京大学第三临床医学院_骨科
作者单位北京大学第三医院骨科,100191
推荐引用方式
GB/T 7714
张志山,周方,田耘,等. 反向微创内固定系统治疗特殊类型股骨近端骨折[J]. 中华创伤杂志,2009,25(1):48-52.
APA 张志山,周方,田耘,&姬洪全.(2009).反向微创内固定系统治疗特殊类型股骨近端骨折.中华创伤杂志,25(1),48-52.
MLA 张志山,et al."反向微创内固定系统治疗特殊类型股骨近端骨折".中华创伤杂志 25.1(2009):48-52.
条目包含的文件
条目无相关文件。
个性服务
推荐该条目
保存到收藏夹
查看访问统计
导出为Endnote文件
谷歌学术
谷歌学术中相似的文章
[张志山]的文章
[周方]的文章
[田耘]的文章
百度学术
百度学术中相似的文章
[张志山]的文章
[周方]的文章
[田耘]的文章
必应学术
必应学术中相似的文章
[张志山]的文章
[周方]的文章
[田耘]的文章
相关权益政策
暂无数据
收藏/分享
所有评论 (0)
暂无评论
 

除非特别说明,本系统中所有内容都受版权保护,并保留所有权利。