动力髋螺钉内固定治疗粗隆间骨折的术后并发症及防治措施

Postoperative complications of Dynamic hip screw and its prevention in the treatment of intertrochanteric fracture

关键词:  粗隆间骨折，动力髋螺钉（DHS），并发症

Key words:  intertrochanteric fracture  dynamic hip screw  complication

摘要:

［目的］ 探讨动力髋技术治疗股骨粗隆间骨折的并发症和防治对策。［方法］ 回顾性分析总结1994年1月～2008年3月采用动力髋技术治疗204例患者中出现的34例术后并发症。［结果］34例并发症包括髋内、外翻11例，下肢旋转畸形6例，成角畸形1例，头转子间距短缩及退钉2例，小粗隆未复位3例，内固定失败1例，髋关节痛3例，膝关节僵硬2例，膝关节疼痛2例，骨折延迟愈合3例。［结论］ 造成并发症的原因是多方面的。主要有手术时机延误导致手术难度的增加，对骨折类型了解分析不充分；手术操作不规范，对所使用器材的设计特点、使用要领不熟悉；术后忽视康复指导和功能锻炼不当以及过早负重。

Abstract:

［Objective］ This study was to investigate the postoperative complications of Dynamic compressive hip (DHS), which were applied to treatment of the intertrochanteric fracture, and to find how to prevent the complications. ［Methods］ After reviewing and summarizing 204 patients, to whom the technique of DHS was applied from January 1994 to March 2008, the postoperative complications occurring in 34 cases of the 204 patients were analyzed. ［Results］ Among the 34 patients, eleven of them had their hip joints ental or lateral extended hip varus or valgus, six patients had lower limbs rotatively deformed, one had lower limb angled deformed, two had the distance between femoral trochanter shorten and screws unscrewed, three with minor trochanter fracture failed to be reduced, one had fracture internal fixed unsuccessfully, three patients had pain in hip joints, two had knee joints stiffened, two had pain in knee joints and three patients had fracture healing delayed. ［Conclusion］ There are many factors resulting in the complications. The main points are summarized in below. The operations became more difficult if they were delayed. The types of fracture couldn't be analyzed and known correctly and completely. The operations weren't performed according to the technical standard. The characteristics of the instruments were unfamiliar, so they couldn't be performed skillfully. After operation, instructing rehabilitation was neglected or functional exercise wasn’t done properly or lifting weight was too early after surgery.