小切口及前方关节囊切开DHS治疗股骨转子间骨折临床分析

目的探讨小切口及前方关节囊切开、DHS内固定治疗股骨转子间骨折的方法和疗效。方法回顾2004年2月-2010年5月以来,我科采用髋外侧小切口及前方关节囊切开、DHS内固定治疗36例股骨转子间骨折患者。切口长度平均约4.8cm,术中使用C-臂X光机透视辅助指导。结果 36例患者均获得随访（其中32例随访至骨折愈合后内固定取出）,时间8～34个月,期间无一例出现骨不愈合、髋内翻、内固定物断裂等相关并发症。按髋关节功能评定：优33例,良2例,可1例,优良率97.2%。结论术中使用髋外侧小切口及前方关节囊切开DHS治疗股骨转子间骨折,内固定操作简单,术后并发症少,疗效可靠,术中内固定牢固,创伤小,出血少,解除了关节囊内压力,减少了术后疼痛,可以早期功能锻炼,恢复快。

Effects of Small Lateral Incision and Anterior Articular Capsule Cutting with Dynamic Hip Screw Internal Fixation on Femoral Intertrochanteric Fracture

Objective To discuss the curative effects of small lateral incision and anterior articular capsule cutting with dynamic hip screw（DHS） internal fixation on femoral intertrochanteric fracture（FIF）.Methods The data of 36 cases with FIF treated by small lateral incision and anterior articular capsule cutting with DHS internal fixation from Feb.2004 to May 2010 were analyzed retrospectively.The mean length of incisions was 4.8cm.The operations were guided by C Arm X Ray Machine.Results All the patients were followed up for 8 to 34 months.All of the patients were satisfied with the outcome.No serious complications,such as bone nonunion,coxa vara or internal fixation break were found.According to Han Yi-sheng’s criteria,33 cases were excellent,2 cases were good,1 case was fair,and the total excellent and good rate was 97.2%.Conclusion The small lateral incision and anterior articular capsule cutting with DHS internal fixation is an effective and easy method without serious complications for FIF.The patients,with less bleeding in operation and less postoperative pains,can perform early functional exercise and recover quickly.