| 摘要 |
A modification to the prototypical compression (dynamic or sliding) hip screw is described which expands the utility and surgical indications of this frequently used fracture fixation device to include the fracture pattern commonly referred to as a "reverse obliquity fracture" of the proximal femur. This fracture pattern is poorly secured with current generation hip screws, frequently necessitating the use of intramedulary fracture fixation devices or external fixation hardware. The described modification blocks telescopic sliding of the femoral head lag screw within the cylindrical barrel of the side plate and allows for secure locking of the lag screw within the side plate, preventing any relative motion between the screw and plate once fracture reduction has been achieved. In a locked mode, the proximal fracture fragment(s) is prevented from displacing laterally relative to the distal (diaphysial) fragment, as occurs commonly when a reverse obliquity fracture or a comminuted intertrochanteric femur fracture is fixed with a conventional hip screw. No change in routine fracture reduction or insertion technique is required to use the Locking Compression Hip Screw. Additionally, the described modification does not preclude use of the Locking Compression Hip Screw in a dynamic or sliding mode, if desired, when used to fix the more common femoral neck or intertrochanteric fracture patterns.
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