锁定钢板固定股骨转子下SeinsheimerⅤ型骨折

Locking plate for internal fixation of Seinsheimer type Ⅴ femoral subtrochanteric fractures

摘要:

［目的］探讨锁定钢板治疗股骨转子下 Seinsheimer Ⅴ型骨折的疗效。［方法］2014 年 9 月—2019 年 1 月采用锁定钢板固定治疗股骨转子下 Seinsheimer Ⅴ型骨折共计 16 例，记录患者围手术期情况及随访结果。［结果］16 例患者均顺利完成手术，手术切口长度 （12.50±1.45） cm，手术时间 （133.75±18.21） min，术中出血量 （493.75±83.42） ml，术后 1 例出现切口脂肪液化。术后随访时间（22.52±5.04）个月，骨折临床愈合时间为（7.88±1.15）个月。末次随访 VAS 为（0.50±0.63）分，髋关节伸屈 ROM （135.88±6.30）°，髋关节 Harris 评分 （88.19±6.28） 分。临床结果评定为优 10 例，良 5 例，可 1 例，优良率 93.75%。［结论］股骨转子下 Seinsheimer Ⅴ型骨折复位困难，锁定钢板内固定术是一种安全有效的手术方式，骨折愈合及临床疗效良好。

Abstract:

[Objective] To explore the clinical outcomes of locking plate for internal fixation of Seinsheimer type V femoral subtrochan- teric fractures. [Methods] From September 2014 to January 2019, 16 patients underwent open reduction and internal fixation with locking plate for Seinsheimer type V femoral subtrochanteric fractures. The perioperative status and follow-up results of the patients were recorded. [Results] All the 16 patients had operation performed successfully with incision length of (12.50±1.45) cm, operation time of (133.75± 18.21) min, and blood loss intraoperatively of (493.75±83.42) ml, whereas a patient got incision fat liquefaction after operation. The postop- erative follow-up period lasted for (22.52±5.04) months on average, while clinical fracture healing achieved in (7.88±1.15) months on aver- age. At the latest follow-up, the patients had VAS score of (0.50±0.63) , hip extension-flexion range of motion (ROM) of (135.88±6.30)°, and Harris score of (88.19±6.28) on average. The clinical outcome was marked as excellent in 10 cases, good in 5 cases, fair in 1 case, with an excellent and good rate of 93.75%. [Conclusion] The Seinsheimer type V femoral subtrochanteric fractures is difficult for reduction and fixation, however, locking plating is a safe and effective surgical method with good fracture healings and satisfactory clinical results.