股骨粗隆间骨折98例的外科治疗体会  

Experience of surgical treatment on comminuted intertrochanteric fractures in 98 patients

作　　者：周华[1] 陈刚[1] 李立[1] 陈江[1] 

机构地区：[1]扬州市江都人民医院骨科,江苏225200

出　　处：《齐齐哈尔医学院学报》2013年第14期2089-2090,共2页Journal of Qiqihar Medical University

摘　　要：目的探讨不同手术方法在不同类型股骨粗隆间骨折患者中的临床疗效。方法对98例股骨粗隆间骨折患者资料回顾性分析。结果 98例患者均获得随访,随访时间2～20月(平均11.6月),多枚针及空心钉固定患者5例均骨愈合,但有2枚针滑出;股骨近端解剖钢板内固定患者,1例出现松质骨螺钉松动退出;加压滑动鹅头钉(DHS)内固定患者,1例出现钉头移出股骨头上方,1例出现侧钢板螺钉断裂,严重髋内翻畸形1例;Gamma钉内固定患者,1例出现股骨干骨折;股骨近端抗旋髓内钉(PFNA)内固定患者11例均骨愈合,尚未发生明显并发症;人工股骨头置换术患者6例术后效果皆满意。结论股骨粗隆间骨折不能一概而论,根据患者年龄和不同类型选择不同方法固定或人工关节置换方能取得满意疗效。Objective To discuss the therapeutic effect of several different surgical treatments on the patients with different types of comminuted intertrochanteric fractures.Methods Among 98 cases of patients,5cases were classified by close restore and internal fixation with scanner wire fixation of cross or combined method,14 cases were classified by internal fixation with anatomical plate,53cases were classified by internal fixation with DHS,9 cases were classified by internal fixation with Gamma,11 cases were classified by internal fixation with PFNA,6 cases were classified by internal fixation with prosthetic replacement.Results 98 cases were followed up for 2 to 20 months（average month 11.6）.Kirschner wire fixation or combined method group were bone healing,but two kirschner wires were slide.Anatomical plate group,1 cases of screw lossening.DHS group,1 cases of cutting-out of cancellous screw,1 cases of nail,1 cases of coax vara,Gamma group,1 cases of femoral shaft fractures,PFNA group,all fractures healed,prosthetic replacement group,effects were satisfying.According to Dong jiyuan＇s criteria,excellent and good in 84 cases（85.7%）,fair 9 cases and poor 5 cases.Conclusions We can not only use some internal fixation to treat comminuted intertrochanteric fractures mechanically or doctrinally,conversely we should choose several different fixation（orif） placement according to patients＇ different ages and their different types of proximal humeral fractures to obtain satisfactory result.

关 键 词：股骨粗隆间骨折 内固定 人工股骨头置换 

分 类 号：R683.42[医药卫生—骨科学]