| 改良扩孔器逆向扩孔DHS内固定术在老年股骨粗隆间骨折的应用 |
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| 引用本文： | 李敬,陈巨坤,周凯,沈斌,倪向明,陈雷.改良扩孔器逆向扩孔DHS内固定术在老年股骨粗隆间骨折的应用[J].中国骨伤,2011,24(5):362-365. |
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| 作者姓名： | 李敬 陈巨坤 周凯 沈斌 倪向明 陈雷 |
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| 作者单位： | 1. 温州医学院第一附属医院骨科,浙江温州,325000
2. 温州市第八人民医院骨科 |
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| 摘 要： | 目的：探讨改良扩孔器结合DHS（MDHS术）治疗老年粗隆间骨折的疗效及手术特点。方法：回顾分析2007年8月至2008年12月收治的老年股骨粗隆间骨折54例，MDHS组与常规DHS组各27例，MDHS组男12例，女15例，年龄69-93岁，平均79-4岁，根据改良Evans分型：I型3例，Ⅱ型12例，Ⅲ型8例，Ⅳ型4例；DHS组中男10例，女17例，年龄66-88岁，平均77-2岁，I型4例，Ⅱ型14例，Ⅲ型6例，Ⅳ型3例。对两组的骨折临床愈合时间、术后下地时间、主钉松动率及髋关节功能Harris评分等进行比较。结果：54例均获得随访，时间21～36个月，平均27．6个月，骨折全部愈合。两组骨折临床愈合时间比较，差异无统计学意义（P〉0．05）。术后下地时间，MDHS组（14．2±2．1）d较DHS组（18．9±3．1）d明显提前（P〈0．05）；主钉松动发生情况，MDHS组（1例）明显少于DHS组（8例）（P〈0．05）。髋关节功能Harris总评分，MDHS组（87．8±4．7）分明显高于DHS组（83．3±7．5）分（P〈0．05）。结论：MDHS具有主钉把持力强，手术适应证广，下地活动时间早，术后并发症少等特点，在治疗骨质疏松性粗隆间骨折中疗效明显优于传统的DHS。
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| 关 键 词： | 股骨骨折 髋骨折 骨折固定术，内 外科手术 老年人 临床对照试验 |
| 收稿时间： | 3/3/2011 12:00:00 AM |
Application of dynamic hip screw with modified reamer in intertrochanteric fracture in the elderly |
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| LI Jing,CHEN Ju-kun,ZHOU Kai,SHEN Bin,NI Xiang-ming and CHEN Lei.Application of dynamic hip screw with modified reamer in intertrochanteric fracture in the elderly[J].China Journal of Orthopaedics and Traumatology,2011,24(5):362-365. |
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| Authors: | LI Jing CHEN Ju-kun ZHOU Kai SHEN Bin NI Xiang-ming and CHEN Lei |
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| Institution: | Department of Orthopaedics, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang, China;Department of Orthopaedics, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang, China;Department of Orthopaedics, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang, China;Department of Orthopaedics, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, Zhejiang, China |
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| Abstract: | Objective:To investigate the therapeutic effect and characteristic of dynamic hip screw with modified reamer(MDHS for short) in the treatment of the intertrochanteric fracture in the elderly.Methods:Fifty four patients with intertrochanteric fracture from Aug.2007 to Dec.2008 were retrospectively analyzed.Among them,27 patients were treated with MDHS,including 12 males and 15 females with an average age of 79.4 years old ranging from 69 to 93 years;according to modified Evans classification,there were 3 cas... |
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| Keywords: | Femoral fractures Hip fractures Fracture fixation internal Surgical procedures operative Aged Controlled clinical trials |
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