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- Bridge-Plating Osteosynthesis of 20 Comminuted Subtrochanteric Fractures with Dynamic Hip Screw
- Spontaneous Femoral Neck Fracture Complicating a Healed Subtrochanteric Fracture--A Case Report
- Simultaneous Treatment of Neglected Femoral Neck and Subtrochanteric Fractures and a Secondary Femoral Shaft Fracture: A Case Report
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- Subtrochanteric Fracture in Young Adult after Cannulated Screw Fixation of Intracapsular Femoral Neck Fracture: A Case Report
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題 名 | Bridge-Plating Osteosynthesis of 20 Comminuted Subtrochanteric Fractures with Dynamic Hip Screw=以架橋式鋼板固定法治療20例粉碎性股骨轉子下股骨幹骨折 |
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作 者 | 李柏成; 于尚文; 謝邦鑫; 蘇君毅; 陳永仁; | 書刊名 | 長庚醫學 |
卷 期 | 25:12 2002.12[民91.12] |
頁 次 | 頁803-810 |
分類號 | 416.26 |
關鍵詞 | 架橋式鋼板固定; 股骨轉子下骨折; 動態型股螺釘; Bridge-plating osteosynthesis; Subtrochanteric fracture; Dynamic hip screw; |
語 文 | 英文(English) |
中文摘要 | 背景:廣泛性股骨轉子下骨折的手術目前難度仍高,而且尚未有公認的單一治療方法。本研究選擇一種常用之鋼板合併架橋式固定法來治療這類複雜性高的骨折。 方法:廣泛性股骨轉子骨折可用Winquist分類法分成三種不同骨折型態,其中第三型骨折因斷位高而無法使用架橋式鋼板固定法,所以並不包括在本研究中。這20例骨折病人中,包含14位男性及6位女性,平均年齡為49歲。我們選擇DHS固定器的原因是它已被廣泛使用,而且手術技術上較為簡便。 結果:所有骨折平均七點六個月癒合。活動指數方面:有18例為9分,2例為6分。疼痛方面:有14例無疼痛,3例為輕度,3例為中度。有2例患肢分別短少1公分及1.5公分。 結論:使用DHS固定器合併架橋式鋼板固定法可使所有Winquist第一型及第二型骨折癒合而無顯著之併發症,所以這是除了新式骨髓腔內骨釘固定法外的另一種治療選擇,這種方法的主要好處是較少的技術性需求。我們的臨床結果令人滿意,其結果與新式骨髓腔內骨釘固定法的文獻報告相當。 |
英文摘要 | Background: A prospective clinical trial was conducted to evaluate the conjunctive use of an extramedullary device and the bridge-planting technique in the treatment of comminuted subtrochanteric fractures with major extension into the femoral shaft. Methods: A Winquist criteria was used to classify 3 fracture patterns. The type 3 fractures were excluded from this study because of great extent of the fracture zone for which the bridge-plating technique is not indicated. There were 14 men and 6 women, with a mean age of 49 (range, 17-76) years. A dynamic hip screw (DHS) with a long side plate was chosen as the fixation device because of the small learning curve. Results: The fractures united at a mean of 7.6(range, 3-15) months postoperatively. Mobility was scored at 9 points in 18 patients and 6 points in 2 patients (Mobility score of Parker & Palmer). Pain was absent in 14, mild in 3, and moderate in 3 patients. Two limbs were shortened by 1 and 1.5 cm, respectively. Conclusion: Our results indicate that DHS fixation using the bridge-planting technique leads to union of all comminuted Winquist types 1 and 2 fractures without major complications, and it is a valuable alternative to new intramedullary devices. This procedure offers the significant advantage of being less technically demanding. |
本系統中英文摘要資訊取自各篇刊載內容。