动力髋螺钉转子间骨折内固定:尖端距离测量对预测内固定失败有用吗?

IF 0.3 Q3 MEDICINE, GENERAL & INTERNAL
Goh Kian Liang, Z. Zamzuri, S. MohdAriff, M. Ma
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引用次数: 1

摘要

引言:动力髋螺钉(DHS)植入物在治疗不稳定转子间骨折中的应用继续引起人们对拉力螺钉切除风险的关注,无论是否对髋臼造成损伤。建议测量尖端顶点距离(TAD),以指导拉力螺钉的最佳放置,并预测螺钉切除的后续风险。在本研究中,对TAD的价值进行了评估,以验证其有用性。方法:对33例股骨粗隆间骨折患者采用DHS治疗进行回顾性研究。患者的人口统计数据来源于他们的病例记录。术后X线片通过前后和侧位X线片上TAD的测量进行回顾。回顾一年随访的放射照片,以描述任何与固定相关的失败或并发症。结果:52%的患者未达到建议的TAD≤25mm。术后平均TAD为25.9mm,老年患者可能达到≤25mm的TAD。两例患者的总并发症发生率为6%。不稳定的左侧骨折被认为是螺钉切除或移位的潜在风险。结论:TAD是指导DHS内固定治疗股骨粗隆间骨折时拉力螺钉最佳位置的一种有价值的测量方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Intertrochanteric fracture fixation with Dynamic Hip Screw: Is tip-apex distance measurement useful for predicting fixation failure?
Introduction: Application of dynamic hip screw (DHS) implant for the treatment of unstable intertrochanteric fractures continues to raise concern related to risk of lag screw cut-out with or without subsequent damage to the acetabulum. Measurement of tip-apex distances (TAD) has been recommended to guide the optimal placement of lag screw and to predict subsequent risk of screw cut-out. In this study, the value of TAD was evaluated to verify its usefulness. Methods: This is a retrospective study of 33 consecutive patients with intertrochanteric fracture treated with DHS. Demographic data of the patients were traced from their case notes. Post-operative radiographs were reviewed by focusing on measurement of TAD on anteroposterior and lateral radiographs. Radiographs at one year follow-up were reviewed to depict any fixation-related failure or complication. Results: Fifty two percent of patients did not achieved the recommended TAD of ≤ 25mm. The mean post-operative TAD was 25.9mm and elderly patients were likely to achieve TAD of ≤ 25mm. The overall complication rate of 6% was attributed to screw cut-out in two cases. The unstable left-sided fracture was identified to be a potential risk for screw cut-out or migration. Conclusion: TAD is a valuable measurement to guide optimal placement of lag screw during DHS fixation of intertrochanteric fracture.
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来源期刊
International Medical Journal Malaysia
International Medical Journal Malaysia Medicine-Medicine (all)
CiteScore
0.40
自引率
0.00%
发文量
73
期刊介绍: International Medical Journal Malaysia (IMJM) is the official journal of the Kulliyyah (Faculty) of Medicine, International Islamic University Malaysia. It serves primarily as a forum for education and intellectual discourse for health professionals namely in clinical medicine but covers diverse issues relating to medical ethics, professionalism as well as medical developments and research in basic medical sciences. It also serves the unique purpose of highlighting issues and research pertaining to the Muslim world. Contributions to the IMJM reflect its international and multidisciplinary readership and include current thinking across a range of specialties, ethnicities and societies.
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