三种内固定方法治疗老年股骨粗隆间骨折95例临床比较

目的对比3种内固定手术治疗对老年粗隆间骨折的治疗效果。方法将95例老年粗隆间骨折患者分为锁定解剖钢板组(A组)、单纯滑动加压髋螺钉内固定系统(DHS)组(B组)、DHS联合空心加压螺钉组(C组)。采用切开复位,分别应用锁定解剖钢板、DHS及DHS联合空心加压螺钉3种内固定方式进行治疗。结果95例患者获得随访8个月至2年、优良率A组64.3%,B组70.5%,C组93.7%。3组优良率比较差异有统计学意义(χ2=11.46,P<0.01)。结论对老年粗隆间骨折的治疗需根据骨折类型、骨质疏松程度及并存病情况,选择更适宜的内固定,可获得更高优良率的临床疗效;DHS联合空心加压螺钉内固定组术后强度、稳定性和优良率明显高于A组及B组,临床疗效满意。

Three Kinds of Internal Fixation Methods for the Treatment of Senile Intertrochanteric Fracture 95 Cases of Clinical Comparison

Objective To compare the clinical effects to treat operatively with 3 different intemal fixa- tion for troohanteric fracture of old people. Methods 95 cases of intertrochanteric fractures in elderly patients were divided into look anatomical plate group （ A group）, simply sliding hip screw fixation system （DHS） group （ B group）, the sliding hip screw fixation system （DHS） Joint hollow compression screw group （ C group）. The use of open reduction, respectively, the application of targeted anatomical plate, sliding hip screw fixation system （DHS） and the sliding hip screw fixation system （DHS） unite hollow compression screw fixation with three kinds of methods for treatment. Results 95 cases of patients were followed for 8 months to 2 years,the excellent rate of A group was 64.3% ,B group was 70.5% ,C group was 93.7%. 3 difference between excellent and good rate whether there are statistically significant （ X^2 = 11.46,P〈0.01）. Conclusion Intertrochanteric fractures in the elderly to be treated in accordance with the type of fracture, the coexist and the degree of osteoporosis patients, a more appropriate choice of internal fixation, the fine will be higher rates of clinical efficacy ; DHS joint hollow screw fixation group after Strength, stability and good rate was significantly higher than group A and group B ,clinical efficacy satisfaction.