锁定异型接骨板治疗老年粗隆间骨折32例临床观察

目的探讨使用锁定异型接骨板（locking compression plate,LCP）内固定治疗老年人粗隆间骨折的疗效。方法回顾性分析老年人粗隆间骨折32例,术前参照Tronzo和Evans分型,Ⅰ型2例,Ⅱ型11例,Ⅲ型13例,Ⅳ型4例,Ⅴ型2例,32例均在C臂下闭式复位后行股骨近端LCP内固定。结果所有病例均获随访,平均时间11.5（6～18）个月。本组平均愈合时间14（10～16）周,达到良好复位29例,存在小转子复位不良4例。患髋关节功能按Harris评分标准,优19例,良10例,可3例,优良率90.6%。结论老年人股骨粗隆间骨折应积极在透视下牵引复位,LCP内固定具有创伤小、固定可靠、并发症少、能早期积极关节功能锻炼、减少卧床时间、提高生活质量等优点,适用于老年粗隆间骨折。

Clinical Observation of the Locking Compression Plates for the Intertrochanteric Fractures in the Aged (32 Cases Report)

Objective To explore the clinical effects of locking compression plates(LCP) internal fixation for the old people suffered from the intertrochanteric fractures.Methods Retrospective analysis of 32 old cases of intertrochanteric fractures was used.According to the Tronzo-Evans typing,the preoperative intertrochanteric fracture types were 2 cases of type Ⅰ,11 cases of type Ⅱ,13 cases of type Ⅲ,4 cases of type Ⅳ and 2 cases of type Ⅴ.The intertrochanteric fractures got closed reduction under the C-arm X-ray equipment followed by proximal femoral LCP internal fixation.Results All cases were followed up for 6 to 18 months,11.5 months in average.29 cases got good reduction,but 4 cases suffered from entotrochanter malreduction.The mean bone union time was 14(10～16) weeks.And Harris standardization of the hip joints was 19 of excellent,10 of fine and 3 of fair.Conclusion LCP internal fixation is a good method with little trauma,reliable fixation,less complications,early positive joint function exercises and short bed time,which can improve the quality of life in the old patients.