摘要
目的测量成年国人股骨上段参数,为股骨转子间骨折内固定设计提供依据。方法随机选取120具正常成人股骨标本(左侧60具,右侧60具),测量颈干角、大转子斜坡弧长、大转子头颈轴长、颈上下缘长及颈最小横径等参数。根据股骨上端解剖形态及股骨转子周围骨折的特点,研制并临床应用双爪钢板手术治疗145例股骨转子周围骨折患者。结果正常颈干角为128．59°±6．31°,大转子斜坡弧长为(5．51±0．58)cm,大转子斜坡倾斜角为42．76°±5．20°,头颈(转子)轴长为(9．42±0．38)cm,各参数间存在相关性。145例患者术后获平均23．6个月随访,骨折均在3～6个月内获临床愈合。其中2例发生爪钩滑脱,未影响最终治疗效果；3例发生髋内翻畸形,其余患者颈干角均在正常范围内。髋关节活动功能正常。无断钩、断钉及钉尖头部穿出等并发症发生。结论股骨转子部骨折内固定物的设计必须符合股骨转子部的解剖特点及生物力学应力分布,应充分利用转子部皮质骨的握持效应。据此设计的双爪钢板临床应用效果较好。
Objective To measure the proximal femoral parameters which can provide anatomic evidence tor the design of internal fixation components tor intertroehanteric fractures of femur. Methods Femoral specimens were harvested randomly from 120 healthy adult cadavers （left 60, right 60） . The neck shaft angle, greater trochanter slope length, tilt angle of greater trochanter, axial length of head and neck, lengths of upper and lower borders of the neck, and the minimum transverse diameter of the neck were measured. On the basis of the anatomic study, a two-claw plate was designed to treat 145 cases of femoral intertrochanteric fractures. Results The femoral neck shaft angle was 128.59°± 6.31°, femoral greater troehanter slope length was （5.51 ± 0.58） cnl, tilt angle of femoral greater trochanter was 42.76° ± 5.20°, and axial length of head and neck was （9.42 ± 0.38 ） cm. There was a correlation between the parameters. All the patients were followed up for a mean time of 23.6 months. The fractures got clinic union in 3 to 6 months, Two cases experienced detachment of claws and hooks but their final outcome was not affected. Three cases suffered coxa rata. All the other cases obtained normal motion function of hips and normal neck shaft angle. No breakage of claw, hook or nail was found in them. Conclusions It is necessary to design an internal fixator that can fit the anatomical features of Chinese femurs in the treatment of intertrochanteric fractures of femur. The two-claw plate designed by us is a good attempt to improve the clinical effect.
出处
《中华创伤骨科杂志》
CAS
CSCD
2006年第10期954-957,共4页
Chinese Journal of Orthopaedic Trauma
关键词
股骨转子间骨折
解剖学
双抓钢板
骨折固定术
内
Femoral intertrochanteric fracture
Anatomy
Two-claw plate
Fracture fixation, internal
