股骨粗隆间骨折术后锁定钢板断裂原因分析

摘要

Objective:To analyze the locking compression plate(LCP) causes the appearance of fracture locking plate for treatment of femoral intertrochanteric fracture after operation,improving the application of the internal fixation for the treatment of intertrochanteric fractures.Methods:From July 2008 to July 2012 120 cases of intertrochanteric fracture were selected,66 cases were male,54 cases were female,age from 24 to 83 years,averaged age 58.5, according to AO classification:type A1 of 33 cases,type A2 of 57 cases,type A3 of 30 cases,hospitalization injury time from 1 h to 5 d,operation from 24 h to 7 d, all patients were treated by locking plate fixation mode compression treatment,postoperative 10 cases appear plate fracture,the reasons of steel plate fracture were analyzed.Results:All cases were followed up,time from 12 months to 2 years,average 15 months. In 10 cases,6 cases of fracture operation due to operational reasons,4 cases due to postoperative fracture reason,there were some defects of locking plate,all 10 cases in the first nail hole fracture of greater tuberosity below.Conclusion:The standardized operation,functional exercise,the right regular reexamination are filming the prevention of femoral intertrochanteric fracture after internal fixation of effective measures of locking plate fracture.%　　目的：分析锁定钢板(LCP)治疗股骨粗隆间骨折术后出现锁定钢板断裂的原因，提高应用此类内固定物治疗粗隆间骨折的临床疗效。方法：选择2008年7月-2012年7月笔者所在医院收拾的120例股骨粗隆间骨折患者，男66例，女54例，年龄24~83岁，平均58.5岁，AO分型：A1型骨折33例，A2型骨折57例，A3型骨折30例，入院距受伤时间1 h~5 d，手术时机24 h~7 d，全部病例采用锁定钢板加压钢板内固定方式治疗，术后10例出现钢板断裂，对钢板断裂的原因进行分析总结。结果：所有病例均获得随访，随访时间12个月~2年，平均15个月。10例钢板断裂患者，因手术操作原因断裂6例，因术后原因断裂4例，锁定钢板也存在一定缺陷，10例病例均在大粗隆下面的第一个钉孔断裂。结论：采用规范手术操作、正确的功能锻炼、定期复诊摄片是防治股骨粗隆骨折内固定术后锁定钢板断裂的有效措施。