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Dołączył: 03 Mar 2011
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Skąd: England
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 Wysłany: Sob 17:04, 19 Mar 2011 Temat postu: asics australia llo mtf fsc bsf |
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Anatomic locking plate treatment of intertrochanteric fractures
10d, 3d bed after isometric contraction of quadriceps and ankle flexion and extension activities, 3 to 4 weeks after the weight-bearing activities help crutches do not get out of bed, according to x ray review of weight-bearing bone callus formation time of the decision. 2 results were followed up 8 to 26 months, an average of 17 months, an average of 5 months, are all healing, no case of varus and internal fixation of hip fracture, loosening, according to Huang Gongyi assessment standards and excellent in 24 cases, good in 8 cases, 2, and poor 0 case. Excellent rate of 94%. Table 1. Table 1 The clinical effect (patients) 3 to discuss more than 3.1 intertrochanteric fractures due to falls for older people with low energy accidental damage, but in recent years, falling from the sky caused by traffic accidents and young adults each year are also high-energy injury increased. Positive view of the current surgical treatment be uniform. Many surgical methods, can be divided into intramedullary and extramedullary fixation. Most scholars believe that the young adults who are better bone marrow external fixation with the elderly who use the less bone intramedullary fixation, clinical reports indicate that the advantages and disadvantages, but serious fractures and osteoporosis are still higher than the failure rate high. Internal fixation with a variety of constantly updated and developed as a system of the anatomic medullary locking external fixation plate, a more complex biological fixation principles, simple,[link widoczny dla zalogowanych], reliable fixation,[link widoczny dla zalogowanych], indicating a good prospect. 3.2 locking plate of the features and advantages of locking plate and screw fixation within the formation, with strong overall stability of the geometry, can provide high-intensity stable internal fixation, to avoid the loss of the initial and secondary reduction. Normal or osteoporosis Author: 122,100 First People's Hospital of Liaoning Province Beipiao 63 * bone can provide sufficient stability at the same time, locking plate and screws into the angle stability mechanism is not dependent on plate and bone friction to provide a stable, bone plates and cortical bone in close contact without the need to reduce the periosteum damage, minimizing the impact on bone blood supply. Since the power screw design used to reduce the steps of the surgery, increasing the holding power of screws pulling. Proximal nail plate into the point as Implantation of the nail distal locking nail holes can, but also to retain the ordinary pressure hole, the pressure to retain the role of ordinary steel,[link widoczny dla zalogowanych], intraoperative flexible choice under the circumstances. 3.3 Indications According to the above characteristics plate for Evan's the type of fracture, especially for crushing gravity and osteoporosis. 3.4 preoperative surgical experience of the full skin traction or traction tibial tubercle to prevent soft tissue contracture, active control and treatment of internal diseases. Fully understand the type of fracture before surgery, the degree of comminuted and osteoporosis situation. Good reduction is a prerequisite to improve fracture stability, fracture reduction, the case should first be a large reduction of free bone fragments and fixed in the main bone, not too much attention to bone with soft tissue dissection, fracture of the complex into simple fractures . Reset when the lesser trochanter hip flexor knees conducive to reset, do not pull through the plate with long screws, such as small hard reset the bone, bone graft area should be sufficient. Note that the maintenance of intraoperative neck shaft angle (which can be appropriately increased) and anteversion in the C-arm fluoroscopy to ensure that the proximal three nail plate in the position of the femoral neck after lower side from the femoral head subchondral 0.5 -1em Department. Locking screw to ensure a one-time implantation, to avoid repeated operations on the bone destruction and reduce the holding power of screw pull. The correct use of technical director, to avoid damage to the lock plate screw hole threads, to ensure that the locking screw and plate accurate. If the direction of deviation from the lock structure failure, the bone plate and screws can not play the advantage of locking mechanism to reduce the overall stability of the nail plate system geometry. Limb after Notes 3.5 in neutral abduction after surgery, anesthesia after the disappearance of a positive response to isometric contraction of quadriceps and ankle flexion and extension exercises, incision in the bed gradually reduce hip flexor knees after practice,[link widoczny dla zalogowanych], 4 to 6 weeks can not help weight-bearing limb function crutches out of bed to practice, insisted on cross-legged,[link widoczny dla zalogowanych], do not side with the principle of non-weight-bearing, to be confirmed by x-ray examination when the callus formation under the protection of more gradual weight-bearing exercise, poor fixation for severely comminuted fractures and bone osteoporosis should be deferred load time. In short, the anatomy of locking plate treatment of intertrochanteric fractures with good mechanical stability and simple, with emphasis on preoperative preparation, intraoperative fracture reduction to improve the quality, focus on the protection of soft tissue, standardized instrumentation, and postoperative functional exercise guide, can be achieve good clinical outcomes.
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