短重建钉治疗老年难复型股骨粗隆间骨折的临床观察  

The exploration of short reconstructed nail for geriatric patients with irreducible intertrochanteric fracture

作　　者：陈兵[1] 刘利民[1] 高志华[1] 王玮[1] 武京伟[1] 

机构地区：[1]首都医科大学宣武医院骨科,北京100053

出　　处：《北京医学》2017年第2期146-149,共4页Beijing Medical Journal

摘　　要：目的探讨老年难复型股骨粗隆间骨折复位及内固定的有效方法。方法回顾性分析2011年4月至2012年7月我科收治的老年难复型股骨粗隆间骨折手术治疗患者的临床资料,记录患者性别、年龄、骨折原因、就诊时间以及治疗效果等指标。结果本组29例,男13例,平均年龄(72.6±11.7)岁,女16例,平均年龄(78.4±12.5)岁;均为闭合性骨折,随访时间6~18个月,平均(10.4±5.2)个月。难复型骨折占同期所有股骨粗隆间骨折(125例)的发生率23.2%。18例采用改良的手法复位获得成功,占难复型骨折的62.1%;11例采用微创切开复位的方法获得手术成功,占37.9%。所有病例骨折愈合良好,无术后内固定物失效和螺钉切出等不良事件发生。结论对于老年难复型股骨粗隆间骨折,早期明确骨折的复杂性,并采取行之有效的手术方法,能够获得良好的预后。Objective To explore the approach for effective diagnosis, reduction and fixation for geriatric patients with irreducible intertrochanteric fracture. Methods Twenty-nine cases of geriatric irreducible intertrochanteric fracture from April 2011 to July 2012 with surgical treatment were collected. The data were analyzed including gender, age, causes of damage, treatment time and outcome. Results All of the 29 cases were close fracture. The follow-up time ranged from 6 to 18 months. Average follow up time was 10.4±5.2 months. Irreducible fracture accounted for 23.2% of all the intertrochanteric fracture treated in the same period. Eighteen cases （62.1%） were treated with modified close reduction method, and 11 cases （37.9%） were treated with open reduction approach. All cases healed well, and had no internal fixation failure, nail cutting out and other adverse outcomes. Conclusion For patients with geriatric irreducible intertrochanteric fracture, early diagnosis and effective reductive measure are essential for good outcome.

关 键 词：股骨粗隆间骨折 难复型 短重建钉 

分 类 号：R687.3[医药卫生—骨科学]