采用外固定结合康复治疗高龄股骨转子间骨折的临床观察  

Clinical effect of rehabilitation after external fixation in the treatment of intertrochanteric fracture of femur in elderly

作　　者：李强[1] 章耀华[1] 杨华清[1] 韩庆海[1] 杨云[1] 赵殿钊 彭爱民[1] 刘利民[2] Li Qiang;Zhang Yaohua;Yang Huaqing;Han Qinghai;Yang Yun;Zhao Dianzhao;Peng Aimin;Liu Limin(Department of Orthopedics,Beijing Rehabilitation Hospital,Capital Medical University,Beijing 100144,China)

机构地区：[1]首都医科大学附属北京康复医院骨科,100144 [2]首都医科大学宣武医院骨科,100053

出　　处：《骨科临床与研究杂志》2022年第6期328-333,共6页Journal Of Clinical Orthopedics And Research

基　　金：首都卫生发展科研专项(2022-2-2253);北京市石景山区医学重点专科建设项目。

摘　　要：目的探讨外固定结合康复治疗高龄转子间骨折的临床疗效。方法2010年5月至2020年6月首都医科大学附属北京康复医院骨科治疗的高龄转子间骨折患者40例。根据治疗方式的不同将所有患者分为2组,研究组患者采用闭合复位外固定结合康复治疗;对照组采用保守治疗。通过2组患者的髋关节Harris评分、骨折愈合时间、负重行走时间、治疗期间ICU入住率、1年生存率及并发症发生情况等指标评价治疗效果。结果末次随访时,研究组Harris评分(78.9±17.8)分,优于对照组(65.2±13.1)分,差异有统计学意义(P<0.05)。研究组负重时间为(38.6±10.8)d;对照组为(58.4±13.3)d;2组之间负重时间差异有统计学意义(P<0.05)。研究组骨折愈合时间为(116.3±17.6)d;对照组为(123.9±14.9)d;2组之间骨折愈合时间差异无统计学意义(P>0.05)。研究组治疗期间ICU入住率为14.3%;对照组为50.0%;2组患者之间ICU入住率差异有统计学意义(P<0.05)。研究组患者1年生存率为92.9%;对照组为66.7%;对照组患者1年生存率显著低于研究组(P<0.05)。研究组并发症总体发生率为32.1%;对照组为75.0%;2组之间差异有统计学意义(P=0.013)。结论外固定结合康复治疗高龄转子间骨折可以达到满意的治疗效果,并且围手术期的安全性高,为高龄转子间骨折患者的治疗提供了新的的选择。Objective To investigate the clinical effect of rehabilitation after external fixation in the treatment of intertrochanteric fractures of the elderly.Methods From May 2010 to June 2020,40 elderly patients with intertrochanteric fracture were treated in Department of Orthopedics,Beijing Rehabilitation Hospital,Capital Medical University.They were divided into 2 groups according to different treatment methods.The study group was treated by closed reduction and external fixation followed rehabilitation.Control group was treated by supracondylar traction fixation.Harris hip score,fracture healing time,weight-bearing walking time,ICU occupancy rate,1-year survival rate and complications were used to evaluate the therapeutic effect.Results At the last follow-up,Harris scores in study group(78.9±17.8)and control group(65.2±13.1)were significantly different(P<0.05).The time of weight bearing in study group was(38.6±10.8)days,control group(58.4±13.3)days.There was significant difference in weight-bearing walking time(P<0.05).The time of fracture healing in study group(116.3±17.6)d,control group(123.9±14.9)d(P>0.05).The occupancy rate of ICU was 14.3%in study group and 50.0%in control group.There was a significant difference between the two groups(P<0.05).The 1-year survival rate of patients was 92.9%in study group and 66.7%in control group;there was significant difference between the two groups(P<0.05).The overall incidence of complications was 32.1%in study group and 75.0%in control group.The difference between the two groups was statistically significant(P=0.013).Conclusion External fixation followed rehabilitation treatment of intertrochanteric fractures in elderly patients can achieve satisfactory result.The perioperative period is safer.This method provides a better choice for the elderly patients with intertrochanteric fractures.

关 键 词：骨折固定术 髋骨折 康复 转子间 

分 类 号：R683[医药卫生—骨科学]