老年人髋部骨折内固定治疗96例分析  

Analysis of the complications and therapy of internal fixation in old patients with hip fracture

作　　者：曾剑文[1] 谢建军[1] 李国勇[1] 朱锦宇[2] 朱庆生[2] 

机构地区：[1]武警江西总队医院外二科,江西南昌330001 [2]第四军医大学西京医院全军骨科研究所

出　　处：《中国矫形外科杂志》2008年第14期1054-1056,共3页Orthopedic Journal of China

摘　　要：[目的]比较动力髋螺钉（dynamic hip screw，DHS）、髓内钉、多枚钉3种内固定方法治疗老年人髋部骨折的疗效。[方法]1997年6月～2003年6月共收治60岁以上老年人髋部骨折患者178例。行手术内固定治疗128例，96例获得12～83个月（平均41．5个月）的随访，通过病例复习和随访，获得以下资料包括年龄、性别、手术方式、助能恢复及并发症发生情况。分别按手术方式、年龄分组比较其疗效和并发症发生情况。通过计算发生并发症患者的平均年龄，对手术风险性进行预测。[结果]本组96例，术后功能恢复良好79例，可及差17例；良好率82．3％。术后发生并发症11例，发生率11．5％，其中术后早期诱发原有合并症3例。DHS内固定组和髓内钉内固定组的功能恢复明显优于多枚钉内固定组（P〈0．05）；70岁以上年龄组功能恢复明显差于70岁以下年龄组；以上比较均有统计学意义。11例发生并发症患者的平均年龄为82岁。其中术后早期诱发原有合并症的3例患者平均年龄为92岁．[结论]老年人髋部骨折因合理选择内固定材料，动力髋螺钉、髓内钉为首选，适用于各种不同类型的骨折。[ Objective] To compare the effect and complication incidence among different therapy ways in old patients with hip fracture. [ Method] The research concluded 178 cases of hip fractures in old-aged patients ,which were treated from June 1997 to June 2003. Of all cases, 128 cases received internal fixation therapy and 96 cases were followed up （ mean time of 41.5 months）. The obtained data included age, sex, operation method, functional restoration, complication incidence. According to operation ways and age,all patients were divided into variable groups and their therapeutic effects and complication were compared. After calculating the mean ages of patients with complication, the prediction of the operation risk was made and its impressive factors was analyzed. [ Result] Of 96 cases,79（ 82.3% ） received good functional restoration. Eleven（ 11.5% ） cases had complications after operation ,3 cases were early complication. The functional restoration in DHS internal fixation group and intramedullary pin internal fixation group was better than that in multi-pin internal fixation group （P 〈0.05 ）. Patients in the group of ages above 70 had a bad functional restoration. The average age in 11 cases with complication was 82 years old. The mean age of 3 cases with early complication was 92 years old. [ Conclusion ] Suitable internal fixation materials should be selected in the therapy of oldaged hip fl＇actures. DHS and intramedullary pin, especially muhi-pin, can meet the need of fracture union of various types and ages.

关 键 词：髋部骨折 老年骨折 内固定 并发症 危险因素 

分 类 号：R687.3[医药卫生—骨科学]