股骨转子下骨折XXX 医院骨科XXXRussell-Taylor 分型I 型：骨折未累及梨状窝A ：骨折未累及小转子B ：骨折累及小转子II 型：骨折延伸至梨状窝C ：骨折未累及小转子D ：骨折累及小转子«Seinsheimer分型«AO 分型A3«A1.1A1.2A1.3A2.3A2.2A2.1A3.3A3.2A3.1移位方向近端：髂腰肌、外展外旋肌远端：内收肌«旋转加移位内固定设计及选择«A1.1A1.2A1.3A2.3A2.2A2.1A3.3A3.2A3.1属于不稳定骨折，髓内固定首选风险：不稳定导致骨不愈合和失败率高治疗策略：• 骨的质量• 骨折类型• 内植物的选择• 复位• 内植物放置治疗选择：重建锁定钉（建议）治疗选择：钢板的比较治疗选择：钢板的比较（LP 应力分布更好）骨不连的治疗：角钢板骨不连的治疗：角钢板，纠正内翻畸形骨不连的治疗：Diamond concept（坚强固定+BMP ）骨不连的治疗：Diamond concept（坚强固定+BMP ）骨不连的治疗：Diamond concept（坚强固定+BMP ）失败• 内固定质量• 患者骨量• 植入物选择不当• 复位欠佳• 固定技术不良• 理念混乱Surgical implants are exposed to severe working conditions,including mechanical loading (cyclic and shock), chemicalaggression (body fluids) and the static or dynamic contactbetween the implant materials or the state of implant-to-bonecontact .Therefore,a wide range of failure mechanisms may occur, including fatigue, corrosion, wear, fretting and combinations of them.The mechanical failures of metallic implants may also be influenced by several other factors, including the design, material selection, manufacturing practice, improper installation,postoperative complications and misuse .Investigation of a fatigue failure in a stainless steel femoral plateJB. Marcomini a, n , C.A.R.P. Baptista a , J.P. Pascon a , R.L. Teixeira b , F.P. Reis 9-19 周贤云 男 40 岁 B0065572入院时间： 2016-12-15手术时间： 2016-12-19主诉：摔伤致右髋部疼痛，无法行走3 小时体检：右侧髋部周围肿胀明显，压痛（+ ），下肢活动受限。左下肢感觉无异常，远端末梢循环正常，足背动脉搏动存在，足趾活动正常，余肢体无殊。诊断：右股骨粗隆下骨折 右股骨头坏...
