老年骨质疏松性股骨转子间骨折植入物置入固定并综合治疗的特征分析  

Characteristics of implantation fixation combined with comprehensive therapy for treatment of intertrochanteric fractures of elderly patients with osteoporosis

作　　者：王骏骅[1] 耿德春[1] 杨惠林[1] 徐耀增[1] 

机构地区：[1]苏州大学附属第一医院骨科,江苏省苏州市215006

出　　处：《中国组织工程研究与临床康复》2011年第52期9873-9876,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:对股骨转子间骨折患者的植入物治疗的特点需要进行深入的分析。目的:分析老年骨质疏松性股骨转子间骨折植入物置入固定复合综合治疗方法的特点。方法:回顾性分析328例老年股骨转子间骨折病例,统计骨质疏松性股骨转子间骨折受伤原因、合并骨折及内科合并症情况,并对治疗方式和结局进行分析。结果与结论:所有股骨转子间骨折患者中,年龄≥65岁的骨质疏松性转子间骨折患者比例达72.6%,其中9.5%合并其他部位骨折,46.3%具内科合并症。84.5%获得植入物置换治疗,优良率分别为:动态髋螺钉内固定85.6%、股骨近端抗旋髓内钉或γ钉固定90.9%、全髋或人工股骨头置换86.7%。可见老年骨质疏松性股骨转子间骨折患者发病率较高,治疗以髓内固定的效果最佳,治疗时应综合考虑其年龄、骨折类型、骨质疏松和内科合并症严重程度。BACKGROUND： Characteristics of implantation fixation for treatment of intertrochanteric fracture patients is still unclear. OBJECTIVE： To analysis the characteristics of implantation fixation combined with comprehensive therapy for treatment of intertrochanteric fractures of elderly patients with osteoporosis. METHODS： Retrospective analysis of 328 elderly patients with intertrochanteric fracture and osteoporotic was performed to collect the cause of the injuries, combined fractures and medical complications. Surgical approach and treatment outcome were analyzed. RESULTS AND CONCLUSION： The patients ≥65 years old with osteoporotic intertrochanteric fractures accounted for 72.6%, the percentage of cases with combined fractures and medical complications were 9.5% and 46.3% respectively. 84.5% patients accepted surgical treatment. Excellent rates were 85.6% of dynamic hip screw fixation, 90.9% of proximal femoral nail anti-rotation or γ nail fixation, and 86.7% of total hip or artificial femoral head replacement. Intertrochanteric fractures are easy to take place in elderly patients with osteoporosis and intramedullary fixation is the best treatment for intertrochanteric fractures. For osteoporotic intertrochanteric fractures patients, their age, types of fractures, and the severity of osteoporosis and medical complications should be concerned when treatment.

关 键 词：骨质疏松 股骨转子间骨折 老年人 发病特征 治疗 髓内固定 

分 类 号：R318[医药卫生—生物医学工程]