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find Author "葛伟" 2 results
  • 锁定加压钢板内固定失败原因分析

    目的 分析锁定加压钢板(locked compression plate,LCP)内固定失败原因。 方法 回顾分析2006 年1 月- 2010 年2 月行翻修术的16 例LCP 内固定失败患者临床资料。男11 例,女5 例;年龄19 ~ 48 岁,平均32.7岁。肱骨骨折3 例,桡骨干骨折2 例,胫骨骨折5 例,股骨骨折6 例。伤后至手术时间4 h ~ 10 d,平均2.5 d。术后2.5 ~ 14.0个月内固定失败,其中螺钉退出3 例,钢板断裂7 例,断钉4 例,骨折移位2 例。 结 果 翻修术后16 例均获随访,随访时间4 ~ 20 个月,平均8 个月。术后3.5 ~ 8.0 个月骨折均愈合。内固定失败原因:LCP 选择错误2 例,螺钉选择错误3 例,螺钉过多、过密4 例,LCP 与普通钢板运用原则不清4 例,未正确运用手术器械1 例,骨折不愈合2 例。 结论 严格掌握LCP 内固定运用原则,选择适当的LCP 及螺钉,熟练掌握微创技术及正确使用手术操作器械,是避免内固定失败的关键。

    Release date:2016-09-01 09:04 Export PDF Favorites Scan
  • Effectiveness analysis of surgical treatment of ipsilateral femoral neck fracture and subtrochanteric fracture

    Objective To discuss the effectiveness of intramedullary nail fixation with selective cable wiring in the treatment of ipsilateral femoral neck fracture and subtrochanteric fracture. Methods Between June 2012 and December 2015, a total of 19 patients with ipsilateral femoral neck fracture and subtrochanteric fracture underwent closed reduction of femoral neck fracture and intramedullary nail fixation combined with selective cable wiring. There were 5 males and 14 females with a median age of 52 years (range, 35-77 years). The cause of injury included traffic accident injury in 17 cases and falling injury in 2 cases. According to Garden classification for femoral neck fractures, 7 cases were rated as type Ⅱ, 8 as type Ⅲ, and 4 as type Ⅳ. Femoral subtrochanteric fractures were classified by Seinsheimer classification, with 9 cases as type Ⅱ, 5 as type Ⅲ, 3 as type Ⅳ, and 2 as type V. The interval from injury to operation ranged from 2 to 7 days with an average of 3.7 days. Results The operation time was 58-125 minutes (mean, 82.4 minutes) and the intraoperative blood loss was 225-725 mL (mean, 289.5 mL). All incisions achieved healing by first intention and no early complication such as infection was observed. All patients were followed up 12-18 months (mean, 13.9 months). At 1 month after operation, the tip apex distance was 9-23 mm (mean, 15.2 mm). All patients achieved bone union with the healing time of 18-42 weeks (mean, 27.4 weeks). One case of hip varus and femoral neck re-displacement (femoral neck shaft angle was 122°) occurred at 3 months after operation, which achieved bone union at 42 weeks after operation. Five patients complained of postoperative pain with the visual analogue scale (VAS) score of 1-3 (mean, 1.8), which did not influence normal life. A total of 16 patients recovered preoperative hip function. During follow-up, no fracture nonunion, femoral head necrosis, implant failure, screw cut-out, and loosening of cable wiring was observed. The Harris hip score (HSS) was 72-92 (mean, 82.8) at last follow-up and 15 patients (78.9%) achieved good hip function. Conclusion Intramedullary nail fixation combined with selective cable wiring was effective in the treatment of ipsilateral femoral neck fracture and subtrochanteric fracture.

    Release date:2017-09-07 10:34 Export PDF Favorites Scan
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