老年人股骨转子间骨折的动力髋部螺钉治疗

目的：探讨动力髋螺钉（DHS）内固定手术治疗老年人股骨转子间骨折的方法及临床效果。方法：对2005年1月-2008年1月通过DHS手术治疗、得到随访的老年人股骨转子间骨折67例作病例回顾性分析，探讨老年人股骨转子间骨折的特点及DHS内固定手术的技巧。结果：术后随访时间为12～36个月，平均16．5个月。住院期间无死亡病例，疗效评定为优28例，良33例，可6例，优良率为91％。共有7例发生了术后并发症，其中，髋内翻1例，肺部感染1例。泌尿系感染2例，深部静脉血栓1例，压疮2例。结论：老年人股骨转子间骨折多发生于低能量损伤，多合并内科疾病，DHS可以对其进行有效的固定，并且具有操作方便、手术时间短、出血少的优点。手术前后进行骨质疏松及伴发的内科疾病的治疗和控制十分重要。

Effects of DHS in the treatment of senile intertrochanteric fractures

Objective： To evaluate the effects of DHS in the treatment of senile intertrochanteric fractures. Methods： The retrospective study covered 67 patients over 60 years old who had undergone operations with DHS reduction and internal fixation from January 2005 to January 2008. The characteristics of clinical manifestations and curative effects of the senile intertrochanteric fractures were evaluated. And also the operation techniques were assessed. Results： All the patients were followed up for a mean time of 16.5 months（from 12 to 36 months）. No patient died during hospitalization. The result was excellent in 28 cases, good in 33 cases, and fair in 6 cases. The excellent and good rate was 91%. 7 cases had postopera- tive complications, 1 coax vara, 1 lung infection, 2 urinary infection, 1 deep venous thrombosis and 2 bedsore. Condusiom The senile intertroehanterie fractures are often caused by low energy injuries and different from those of the young. Most of the senile patients suffer internal diseases and osteoporosis which increase the diflqeuhies of internal fixation. But DHS in- ternal fixation is an ideal method because of its easy technique, less operation time and less trauma. The treatment of the accompanied internal diseases and osteoporosis before and after operation is very important.