股骨近端解剖锁定钢板结合小切口治疗老年复杂型股骨粗隆骨折疗效分析  

Proximal femur locking plate combing with internal fixation via a small incision for complex intertrochanteric fractures in elderly patients

作　　者：陈成[1] 马林[1] 王盛明[1] 

机构地区：[1]南京中医药大学姜堰附属医院骨科,江苏姜堰225500

出　　处：《海南医学院学报》2011年第12期1652-1654,1658,共4页Journal of Hainan Medical University

基　　金：海南医学院科研基金资助学报项目(0020110454)~~

摘　　要：目的:探讨应用股骨近端解剖锁定钢板结合小切口内固定治疗老年复杂型股骨粗隆骨折的优势。方法:27例老年股骨粗隆间骨折(Evens分型3型以上)患者采用股骨近端解剖锁定钢板结合小切口内固定治疗,选择同期滑动加压髋螺钉(DHS)系统(30例)及髓内固定系统(25例)治疗老年3型以上股骨粗隆骨折患者作为对照,观察3种治疗方法的效果。结果:27例随访6～24个月,平均16个月,均骨性愈合,优良率为92.6%,并发骨折延迟愈合1例,未出现断钉、断板、髋内翻、关节僵直等并发症。股骨近端解剖锁定钢板结合小切口内固定患者手术时间、出血量、骨折愈合时间较DHS系统、髓内固定系统缩短或者减少,优良率较DHS系统(83.4%)和髓内固定系统(88.6%)提高。结论:股骨近端解剖锁定钢板结合小切口内固定治疗老年复杂型股骨粗隆骨折具有手术创伤小,操作简单,手术时间短,抗旋转能力较强的优点,并且降低了髓内固定引起栓塞的风险,值得推广。Objective： To explore the effects of proximal femur locking plate combing with internal fixation via a small incision for complex intertrochanteric fractures in elderly patients.Methods： Twenty-seven elderly patients with complex intertrochanteric fractures,that were categorized as third grade of Evens or above were treated with proximal femur locking plate combing with internal fixation via a small incision（treatment group）,their counterparts treated with DHS（30 cases） and intramedullary nailing system（25 cases） were also enrolled into this study.Treatment effects of the three groups were observed and compared.Results： An average of 16 months follow-up conducted on the 27 cases ranging from 6-24 months showed good and excellent outcomes ratio of 92.6%,significant higher than the 83.4% of the DHS group and 88.6% of those underwent intramedullary nailing system treatment,delayed bone healing was observed in 1 case,no screw breakage,inward hip joint,stiffness of joint was observed.The treatment group showed shorter operation time,less bleeding volume,shorter recovery time comparing with the latter two groups.Conclusion：With advantages of less trauma,simper procedure,shorter operation time,and stable infixation,proximal femur locking plate combing with internal fixation via a small incision is effective on complex intertrochanteric fractures in elderly patients,it′s worth for application in large scale.

关 键 词：股骨近端解剖锁定钢板 小切口 老年 复杂型股骨粗隆骨折 

分 类 号：R683.42[医药卫生—骨科学]