骨小梁指数及手术方式对高龄股骨粗隆间骨折内固定的影响研究  

Effect of singh index and operation mode on internal fixation in elderly patients with femoral intertrochanteric fracture

作　　者：王铁军[1] 张彪[1] 杨涛[2] 刘书茂[1] 

机构地区：[1]北京市大兴区人民医院骨科,北京102600 [2]北京市大兴区人民医院放射科,北京102600

出　　处：《中国医药导报》2012年第25期55-57,共3页China Medical Herald

摘　　要：目的探讨骨小梁指数(singh指数)及手术方式与高龄股骨粗隆间骨折内固定效果的关系,为改进手术治疗高龄股骨粗隆间骨折提供有效的科学依据。方法回顾性分析本院2007年1月～2011年6月收治的高龄股骨粗隆间骨折患者97例的临床资料。根据固定材料将患者进行分组:动力髋部螺钉41例,股骨近端髓内钉23例,角钢板16例,空心螺纹钉17例。分析所有患者的骨折Evans分型、singh指数、手术方式、手术失败率及其相关性。结果角钢板内固定失败率最高(37.50%),其次为空心螺纹钉(23.53%),股骨近端髓内钉失败率较低(8.70%),动力髋部螺钉失败率最低(7.32%);角钢板内固定失败率明显高于股骨近端髓内钉和动力髋部螺钉,差异有统计学意义(P<0.05)。患者骨折类型越严重,内固定失败率越高,其中,Ⅰ型骨折内固定失败率最低(2.6%),Ⅴ型骨折内固定失败率最高为(66.7%),相互间比较,差异有统计学意义(P<0.05)。患者骨质疏松singh指数越低,内固定失败率越高,其中,Ⅰ型骨质疏松singh指数内固定失败率最高(55.6%),Ⅵ型骨质疏松singh指数内固定失败率最低(0),相互间比较,差异有统计学意义(P<0.05)。手术方法、singh指数、骨折类型与内固定失败均具有一定程度的相关性(P<0.05)。结论根据高龄股骨粗隆间骨折患者的骨折类型和骨质疏松singh指数进行常规评定,骨折类型低于Ⅲ级、骨质疏松singh指数高于Ⅲ级患者宜行内固定术,手术方式以动力髋部螺钉和股骨近端髓内钉为宜,其余患者可采取保守治疗,也可采用常规内固定术联合局部植骨或骨水泥内固定。Objective To investigate the relationship between singh index, operation mode and internal fixation effect in elderly patients with femoral intertrochanteric fracture, in order to provide effective scientific basis for improvement of operation treatment for elderly femoral intertrochanteric fracture. Methods Clinical data of 97 elderly patients with femoral intertrochanter fracture in our hospital from January 2007 to June 2011 were retrospectively reviewed. According to fixation materials, patients were grouped： 41 patients used dynamic hip screw, 23 patients used proximal femoral intramedullary nail, 16 patients used angle steel, 17 patients used hollow thread nail. Fractures of Evans type, singh index, operation mode, operation failure rate and correlation among all patients were analyzed. Results The internal fixation failure rate of angle plate was the highest （37.50%）, followed by the hollow thread nail （23.53%）, the internal fixation failure rate of proximal femoral nail was lower （8.70%）, which of dynamic hip screws was the lowest （7.32%）. The internal fixation failure rate of angle plate was significantly higher than that of proximal femoral nail and dynamic hip screw, the differences were statistically significant （P 〈 0.05）. More severe fracture types of patients had, while higher of internal fixation failure rate was. The internal fixation failure rate of type Ⅰ fracture was the lowest （2.6%）, which of type Ⅴ bone fracture was the highest （66.7%）, the difference was statistically significant （P 〈 0.05）. Lower of osteoporosis singh index of patients had, while higher of internal fixation failure rate was. The internal fixation failure rate of type Ⅰ osteoporosis singh index was the highest （55.6%）, which of type Ⅵ osteoporosis singh index was the lowest （0）. The difference was statistically significant （P 〈 0.05）. There was a certain degree of correlation between operation method, singh index, type of fracture and internal fixation failure. Co

关 键 词：骨小梁指数 手术方式 高龄 股骨粗隆间骨折 内固定术 

分 类 号：R683.42[医药卫生—骨科学]