老年股骨粗隆间骨折不同内固定方式的临床意义

目的比较老年股骨粗隆间骨折不同内固定方式的选择与疗效。方法总结本院不同时期老年股骨粗隆间骨折内固定治疗182例,DHS固定58例,空心加压螺钉42例,PFN26例,解剖钢板56例。比较不同内固定方式的疗效与并发症。结果 182例中获得随访159例,随访率87.4%,随访时间8～62个月,平均19.1个月。在稳定性骨折中几种内固定临床疗效差异无显著性意义,优良率分别是:DHS82%,空心加压螺钉89%,PFN86%,解剖钢板88%,不稳定骨折术后疗效及并发症各异。结论老年股骨粗隆间骨折的治疗应根据患者全身状况、骨折类型、骨质疏松及髓腔情况,合理选择内固定方式,制定正确的康复锻炼,能有效减少并发症。

The clinical effect of different internal fixation for the elderly femoral intertrochanteric fractures

Objective To compare the clinical effect of different internal fixation for the erderly inetertrochanteric fractures.Methods 182 cases of over 65 years old with intertrochanteric fractures were operated with four different internal fixation:58 cases with dynamic hip screw (DHS) and 42 cases with hollow compression screw, fixation with PFN in 26 cases, open reduction and fixation with anatomic plate in 56 cases; The clinica1 effect and the complication of the operation were evaluated.Results 159 cases from 182 cases were followed up for 8-62 months (mean 19.1 months) postoperatively, The excellent and good rate of the hip joint in DHS group, hollow compression screw group, PFN group and the anatomic plate group were 82%, 89%, 86%, 88% respectively.There were no significant differences between the four groups in the stable fracture and there were different clinica1 effect and complications in the unstable fracture.Conclusion The treatment of the femoral intertrochanteric fractures in the elderly people was chosen according to the general condition of the body , the type of the fracture, the degree of osteoporosis and the condition of the bone cavity, the complication of the fracture can be reduced effectively if the internal fixation was used reasonably and the rehabilitation exercise was performed perfectly.