经皮椎体后凸成形术论文 (1)

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1、植骨在DHS固定治疗股骨粗隆间骨折中的作用作者：徐锋，吕建元，洪嵘，蒋铭，吴晓峰，程翔作者单位：南京中医药大学附属昆山中医院骨科，江苏昆山【摘要】目的探讨植骨在动力髋螺钉(dynamichipscrew，DHS)内固定治疗股骨粗隆间骨折中的临床作用。方法2004～2007年我院收治60例Evans分型Ⅰ～Ⅳ型股骨粗隆间骨折病例，采用动力髋螺钉治疗股骨粗隆间骨折。手术分两组，术中不植骨组30例，采用常规实心三联扩孔器扩孔DHS内固定；术中植骨组30例，采用我院自行研制的DHS空心扩孔器扩孔，取骨、植骨，DHS内固定，术后进行随访比较。

2、结果采用黄公怡［1］髋关节功能评定标准进行评价，不植骨组30例，优14例，良9例，可4例，差3例，髋内翻7例，术后螺钉切割拔出2例，钢板断裂1例，骨不连2例，优良率76.7％。植骨组30例，优18例，良9例，可2例，差1例，髋内翻3例，术后髋螺钉切割拔出1例，无钢板、螺钉断裂，无骨不连，优良率90.0％。结论DHS内固定治疗股骨粗隆间骨折时，预防性植骨可加速骨折愈合，迅速重建内侧支持结构，减少髋内翻及相关并发症。【关键词】股骨粗隆间骨折；动力髋螺钉内固定；植骨TheClinicalApplicationofBoneGraftinth

3、eOperationofIntertrchantericFemurFracturebyDHSXUFeng，LVJianyuan，HongRong，etal(DepartmentofOrthopaedics，KunshanHospitalOfNanjingTraditionalChineseMedicine，Kunshan215300，China)Abstract：ObjectiveTodiscusstheclinicalapplicationofbonegraftintheoperationofDynamicHipScrew(DH

4、S)intheintertrchantericfemurfractures(IFF).MethodsFrom2004to2007，60casesofIFFintypeⅠ～ⅣaccordingtotheEvansclassificationweretreatedbyDHS.Thecasesweredividedintotwogroups.Themethodoftraditionaltriadsolidreamerwasadopttotreat30caseswithoutbonegraftandhollowreamerbydevelop

5、ingindependentlytotheother30caseswithbonegraft.ResultsAcordingtothestandardsofhipfunctionevaluationofHuangGongyi.Thegroupwithoutbonegraft：excellentfor14cases，goodfor9cases，fairfor4casesandpoorfor3cases.Therewere7casesofcoxavara，2casesofhipscrewcutsout，1caseofcollapse

6、ofinternalfixationand2casesoffracturenonunion.76.7％showedexcellentorgoodresult.Thegroupwithbonegraft：excellentfor18cases，goodfor9cases，fairfor2casesandpoorfor1case.Therewere3casesofcoxavara，1casesofhipscrewcutsoutandnocaseofcollapseofinternalfixationorfracturenonunion

7、.90.0％showedexcellentorgoodresult.ConclusionTheapplicationofpreventivebonegraftintheoperationofIFFbyDHScanhastenthegrowthoffracture，quicklyreconstructthemedialsupportstructureofhipandreducetheincidenceofcoxavaraandtheotherrelatedcomplications.Keywors：intertrochantericf

8、emurfractures；dynamichipscrew；internalfixation；bonegraft股骨粗隆间骨折是一种高能量损伤，多见于老年人，损伤机制复杂。动力髋螺钉(dynamichipscrew，DHS)治疗股骨粗