不同方法治疗老年股骨粗隆间骨折的临床分析  

Treatment of Intertrochanteric Fracture in Aged Patients by Different Methods

作　　者：崔风国[1] 宋维[1] 丛皎[1] 李国顺[1] 

机构地区：[1]德州市人民医院骨科,山东省德州市253014

出　　处：《组织工程与重建外科杂志》2010年第1期38-40,共3页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探讨不同方法治疗老年股骨粗隆间骨折安全有效的内固定方法、临床效果及其临床适应证。方法对58例老年股骨粗隆间骨折患者分别采用股骨近端解剖型锁定钢板固定14例,动力髋螺钉(Dynamic hip screws,DHS)固定24例,股骨近端解剖型钢板固定20例,比较3组患者术中失血量、手术时间、骨质劈裂情况及骨折愈合时间,术后Sander's评分和并发症发生情况,并进行统计学分析。结果术后患者均随访8～36个月,平均18个月。3组术式的优良率分别为92.9%、92%、90%。结论不同方法治疗老年股骨粗隆间骨折的临床效果都很满意,但适应证各有不同。手术方式应根据骨折类型、年龄、体质因素及患者骨质疏松程度,结合内固定特点选择最佳治疗方案。对伴有严重骨质疏松的高龄者,适合选用解剖型锁定钢板固定,对EvansⅠ、Ⅱ型和部分Ⅲ型患者适合选用DHS固定,对Ⅳ、Ⅴ型患者适合选用股骨近端解剖型钢板固定。Objective To discuss the clinical effect and indication of different methods for the treatment of intertrochanteric fracture in aged patients. Methods A total of 58 aged patients with intertrochanteric fracture were analyzed retrospectively. Anatomical locking plate of proximal femur was used in group A （n=14）. Dynamic hip screws （DHS） and anatomical plate of proximal femur were used in group B （n=24） and group C （n=20） respectively. The bleeding volume, operative and healing time were compared with different methods. Results All patients were followed up for 8-36 months （18 months on average）. According to Sander＇s for scoring, the choiceness rate was 92.9%, 92% and 90% in group A, B and C. Conclusion In the treatment of intertrochanteric fracture in aged patients, different methods have own indication. The anatomical locking plate is effective for aged patients with severe osteoporosis. The DHS fixation is suitable for Evans Ⅰ, Ⅱ and some m type fracture. The anatomical plate of proximal femur was used in Evans Ⅳand Ⅴ type fracture.

关 键 词：老年 股骨粗隆间骨折 内固定 

分 类 号：R683.42[医药卫生—骨科学]