骨质疏松患者不稳定性股骨转子间骨折锁定板固定治疗体会

目的探讨高龄骨质疏松不稳定性股骨转子间骨折的锁定板固定疗效。方法分析2006年2月—2011年1月50例高龄骨质疏松不稳定性股骨转子间骨折患者应用锁定板固定疗效。结果经过治疗后,50例患者3例发生骨不连,2例固定失败,3例患者出现股骨头坏死。不同导针方向的锁定板固定治疗的固定失败和股骨头坏死出现率对比无明显差异(P>0.05);但是分散型出现骨不连的几率明显高于其他三型(P<0.05)。正常骨连接型平均手术时间为(16.4±6.3)h,骨不连型(26.3±4.8)h(P<0.05)。股骨头坏死型平均手术时间为(15.3±3.8)h,无股骨头坏死型为(25.3±1.9)h(P<0.05)。结论高龄骨质疏松不稳定性股骨转子间骨折的锁定板固定治疗是良好有效的办法,其骨不连、固定失败、股骨头坏死发生率低。

Treatment of locking plate fixation on elderly osteoporotic unstable intertrochanteric fractures

Objective To discuss the effect of locking plate fixation effects of elderly osteoporotic unstable intertrochanteric fractures.Methods Follow-up analyzed 50 cases of elderly osteoporotic unstable intertrochanteric fracture efficacy of locking plate fixation from February 2006 to January 2011.Results After treatment,in 50 patients found 3 patients with nonunion,2 patients was fixation failure,3patients with femoral head necrosis.Different needle in the direction of the locking plate fixation for the treatment failure group and the fixed rate of femoral head necrosis in contrast had no significant difference(P>0.05);but there distributed risk of nonunion was significantly higher than the other three groups(P<0.05).Normal bone connections mean operative time was 16.4 hours and 26.3 hours of nonunion group between the two groups were significantly different(P<0.05).At the same time of femoral head necrosis group mean operative time was 15.3 hours,no femoral head necrosis group was 25.3 hours,between the two groups was significant difference(P<0.05).Conclusions The elderly osteoporotic unstable intertrochanteric fractures of the locking plate fixation is a good and effective way,its nonunion,fixation failure of femoral head necrosis rate is low.