不同手术体位应用股骨近端锁定板治疗老年股骨粗隆间骨折的疗效分析

目的探讨不同手术体位下应用股骨近端锁定板治疗老年粗隆间骨折的临床疗效。方法选取47例老年股骨粗隆间骨折患者,按不同手术体位随机分为仰卧位组23例和侧卧位组24例,以切开复位、应用股骨近端锁定板内固定治疗。骨折按Evans-Jensen分型:Ⅲ型36例,Ⅳ型11例。结果全部获得随访,术后随访时间6～60个月,平均20.4个月。髋关节功能按Harris评分标准,仰卧组:优12例,良7例,可3例,差1例,优良率为82.6%;侧卧组:优10例,良11例,可1例,差2例,优良率为87.5%。结论两组不同手术体位,应用股骨近端锁定板治疗老年粗隆间骨折临床效果相当。与平卧位相比,侧卧位术中手术时间短,出血量少,是治疗老年股骨粗隆间骨折安全、有效的选择之一。

The clinical study of treatment of intertrochanteric fractures in elderly patients by using proximal femoral locking plate in different surgical positions

Objective To investigate the efficacy of treatment of intertroehanterie fractures （ITF） by using proxi- mal femoral locking plate in different surgical positions. Methods 47 eases of patients with ITF were randomized divided into two groups by surgical positions （supine= 23;lateral deeubitus= 24） were treated by means of open reduction and proximal femoral locking plate internal fixation. Results All patients were followed up for 6-60 months. According to Harris hip function score criteria, the hip functions were excellent in 31 eases, good in 12 cases and fair in 4 cases, the excellent and good rate was 91.5%. Conclusion Proximal femoral locking plate internal fixation is the credible method for intertrochanteric fractures in the elderly patients in two surgical positions. Comparing with supine group, the lateral decubitus group have significant differences in the operative time, blood loss（P〉0.05）.