动力髋螺钉结合磷酸钙骨水泥治疗老年股骨转子间骨折  

Dynamic hip screws strengthened by calcium phosphate cement for treatment of old patients with femoral intertrochanteric fracture

作　　者：韩小平[1] 曹力[1] 张克远[1] 李纲[1] 彭理斌[1] 

机构地区：[1]新疆医科大学第一附属医院骨科中心关节外科,乌鲁木齐830054

出　　处：《中华创伤骨科杂志》2009年第12期1114-1117,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨动力髋螺钉（DHS）联合磷酸钙骨水泥（CPC）治疗老年股骨转子间骨折的疗效。方法对2006年1月至2008年1月收治的60例老年股骨转子间骨折患者进行回顾性研究，其中32例采用DHS治疗，为DHS组；28例应用DHS联合CPC治疗，为联合组。对两组患者的手术方法、术中和术后相关指标及疗效进行评价。结果60例患者术后获得6～24个月（平均14．8个月）的随访。DHS组发生内固定物松动、切割股骨头1例，发生延迟愈合髋内翻畸形3例，发生深静脉血栓2例；Harris评分评定结果：优10例，良16例，可6例，优良率为81．25％。联合组无内固定物松动、不愈合或延迟愈合，未发生髋内翻畸形；Harris评分评定结果：优16例，良10例，可2例，优良率为92．9％。两组患侧髋关节功能比较差异无统计学意义（X^2=4．522，P=0．104）。两组患者手术时间、术中失血量、输血、住院时间、手术前后血红蛋白等临床指标比较差异均无统计学意义（P〉0．05），而卧床时间差异有统计学意义（P〈0．05）。结论CPC明显提高了骨质疏松患者内固定物的稳定性，能有效解决因骨质疏松导致螺钉在股骨头颈内移动或切出的问题，避免发生内固定失效、不愈合及畸形愈合等。其手术操作简便易行，治疗周期短，临床效果满意。Objective To study the therapeutic effects of internal fixation with dynamic hip screws （DHS） strengthened by calcium phosphate cement （CPC） for treatment of old patients with femoral intertrochanteric fracture. Methods From January of 2006 to January of 2008, 60 old patients with femoral intertroehanteric fracture underwent surgery. Of them, 32 cases used DHS only, and 28 cases used DHS strengthened by CPC. Comparisons were made between the 2 groups. Results All patients were followed up for an average time of 14.8 （6 to 24） months. There was no death in hospital. In simple DHS group, fixation failure happened in 1 case, delayed union and coax varus deformity in 3 cases, and deep venous thrombosis in 2 cases; 81.3% of cases were evaluated as fine or good according to Harris Score. IN DHS plus CPC group, all fractures healed uneventfully; no non-union or malunion occurred; 92.9% of cases were evaluated as fine and good. Conclusion DHS strengthened by CPC is reliable fixation for old pa- tients with intertrochanteric fracture, because it can significantly improve the strength of osteoporotic bone, prevent screw loosening, and promote early healing of fracture.

关 键 词：髋骨折 骨钉 磷酸钙类 骨质疏松 

分 类 号：R686[医药卫生—骨科学]