简介:摘要目的分析股骨粗隆间骨折治疗失败的原因,以及失败后进行翻修治疗的对策。方法通过对我院近十年来收治的29例股骨粗隆间骨折既往治疗失败的病例进行分析,总结分析治疗失败的原因及探索补救措施。结果本组6例患者采取保守治疗均并发髋内翻畸形,其中4例畸形愈合,2例骨折不愈合。使用DHS固定失败5例,均伴发DHS主钉的后上方穿凿。空心钉内固定治疗10例均伴发不同程度的髋内翻畸形、内固定松动,其中畸形愈合3例,不愈合4例,后期并发反粗隆间骨折3例。股骨上段勺型接骨板治疗6例均伴发髋内翻畸形,其中3例不愈合。DCS内固定治疗1例伴发钢板断裂骨折不愈合。90度角型接骨板内固定治疗1例伴发髋内翻畸形。结论内固定方式选择不当、内固定植入不当、康复训练方式不当等是股骨粗隆间骨折治疗失败的原因,正确的病例选择和精确的手术操作是治疗成功的关键。
简介:摘要目的研究内固定法治疗老年性股骨粗隆及周围严重粉碎性骨折。方法对60例患者加压髂螺钉、Gamma钉及单臂外固定架固定治疗。结果经过手术治疗后,优良率达到96.3%,恢复状况良好。结论内固定法治疗老年性股骨粗隆及周围严重粉碎性骨折的方法值得推荐。
简介:摘要目的探讨股骨颈粗隆间骨折实行Gamma钉内固定的护理体会。方法针对2007-2008年60例行股骨颈粗隆间骨折手术的患者,从以下几方面进行手术前后护理1.术前引导沟通做好心理护理及安慰。2.做好手术前的各种准备。3.术后密切观察病情,肢体正确姿势的护理。4.术后肢体功能锻炼的指导。5.预防并发症的护理。结果60例手术患者1-2周下地活动,6-18个月随访,除1例骨折移位,2例复位不理想,1例术后继发股骨颈骨折外其他无一例并发症的发生,手术效果非常满意。结论对Gamma钉内固定治疗股骨颈粗隆间骨折术前、术后患者进行正确合理的护理是减少并发症、提高手术成功率的重要保证。
简介:ObjectiveThepurposeofthisstudyistoobservethedifferenceofthesix-monthmortality,complicationsandfunctionrecoverybetweentheskeletaltractiongroupandDHSgroup.MethodsThisretrospectivestudywasundergoneinthedepartmentoforthopaedicsofLonghuahospital.Accordingtothemethodsoftareatment,87casesweredividedintotwogroups:skeletaltractiongroupandDHSgroup.Tocomaparetherateofsix-monthmoaality,generalcomplications(whichincludepulmonaryinfeetion,bed-sore,minaryinfectionanddeepvenousthrombosis)andcoxayamsbetweenthetwogroups,whiletheHarrishipscoreinthethirdmonthandsixthmonthafterinjurywerealsocompared.Reuslt①Abouttherateofsix-monthmomdity,therewasonecase(2.27%)intheskeletaltractiongroup,andoneeasealso(2.33%)intheDHSgroup,therewasnodifferencebetweenthetwogroups.(P=1.0)②Abouttherateofgeneralcomplications,therewere15cases(34.09%)intheskeletaltractiongroup,and14cases(32.56%)intheDHSgroup,therewasnodifferencebetweenthetwogroups.(P=0.879)③Abouttherateofcoxavarus,therewereseveneases(16.28%)intheskeletaltractiongroup,andoneease(2.38%)intheDHSgroup,therewasnodifferencebetweenthetwogroups.(P=0.068).Butfortheunstableintertrochanteficfractures,thereweresevencasesoutof29(24.14%)intheskeletaltractiongroup,andonecaseoutof31(3.23%),theseshowedthattherateofcoxayamsishigherintheskeletaltractiongroupthanintheDHSgroup.(P=0.045)④Inthethirdmonthafterinjury,theHarrishipscorewas52.99±4.86intheskeletaltractiongroup,and65.87±3.39intheDHSgroup,theseshowedthattheHarrishipscoreishigherintheDHSgroupthanintheskeletaltractiongroup(P<0.0001).Whileinthesixthmonthafterinjury,theHarrishipscorewas84.44±5.79intheskeletaltractiongroup,and85.69±4.07intheDHSgroup,theseshowedthattherewasnodifferencebetweenthetwogroups(P=0.254).Conclusion①Alowmortalityandcomplicationsmorbidityco