股骨转子周围骨折钉板系统内固定失败的翻修

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Abstract Objective: To explore the methods and efficacy of salvage of failed nail-plate system internal fixation for peritrochanteric hip fractures. Methods: The clinical data of failed intertrochanteric area fracture and nonunion after surgery in 28 cases admitted to the Second Affiliated Hospital of Wenzhou Medical University from January 2007 to January 2013 were retrospectively analyzed. Results: The mean operation duration was 170 min (110-280 min). Follow-up time was 7-79 months (mean 29 months). Healing of internal fixation of fracture was 20 cases, the healing rate being 95.2% (20/21). Postoperative hip pain improved significantly, only 3 cases were mild pain, 1 case moderate pain. Ability to walk after surgery: 23 cases of normal walking, 4 cases needed to help with the cane to walk, 1 case was unable to walk. Postoperative Harris hip average score was 83 points (33-100 points) in 28 cases, of whom excellent was in 16 cases, good in 5 cases, medium in 6 cases and poor in 1, excellent rate being 75.0%. Measurements of neck shaft angle was 125° (100°-140°) in X-ray film. Conclusion: Treatment method usually includes the replacement of the prosthesis and re-fixation, after intertrochanteric fracture fixation screw-plate system is failure. The same internal fixation plus graft treatment is used again for young patients and some ability, good bone and good hip status in elderly patients. Selection of kinds of internal fixation bases on types of fixation and bone defects. PFN, DCS and DLK are better choices. Joint replacement is adopted for lower activities and poor bone, head and neck bone defect absorption or hip damage in elderly patients, which are able to obtain satisfactory clinical results.

Key words： hip joint fractures, ununited fractures fixation, internal

Received: 28 April 2014

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	Articles by authors
	LIN Yihuai1
	SHUI Xiaolong2
	KONG Jianzhong2.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2015/V45/I2/134

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