老年粗隆间骨折前内侧皮质支撑方式对患者功能预后的影响

目的 比较不稳定粗隆间骨折前侧皮质阳性或阴性支撑对术后康复结果的影响。方法 选择老年粗隆间骨折140例，分组为阳性支撑组和阴性支撑组，术后观察患者恢复情况及训练计划，记录患者的出血量、负重时间以及Harris、视觉模拟评分（visual analogue scale/score，VAS）等。结果 稳定骨折组术后功能康复及负重时间不受支撑方式的影响，但是手术时间差异有统计学意义（P＜0.05），而不稳定骨折组中阳性支撑与阴性组比较，负重时间、Harris评分以及VAS评分差异均有统计学意义（P＜0.05）。结论 稳定骨折，阳性支撑或者部分的阴性支撑也能达到满意的术后康复效果；对于不稳定骨折，阳性支撑或者中立支撑是必须的，否则会导致严重的术后并发症。术后的CT检查应该常规应用，从而指导术者制定更为个体化的治疗方案。

Anteromedial cortical support for intertrochanteric femurfractures affects the functional prognosis of elderly patients

Objective To compare the effect of positive or negative anterior cortical support for intertrochanteric femur fractures on postoperative rehabilitation of patients.Methods A total of 140 patients with intertrochanteric femur fractures were enrolled. All of them were divided into positive group and negative support group. The patient′s recovery and training plan after operation were observed, and the patient′s bleeding volume, weight-bearing time, Harris scores, and visual analogue scale/score(VAS)were recorded.Results The postoperative functional rehabilitation and weight-bearing time of stable fracture group were not influenced by the type of support， but there was a significant difference in duration of operation(P＜0.05). Significant difference was found in weight-bearing time, Harris scores andVAS scores in positive and negative support of unstable fracture group(P＜0.05).Conclusion For stable fracture, positive support or partial negative support all can achieve satisfactory postoperative rehabilitation. For unstable fracture, positive support or neutral support is mandatory, otherwise it will lead to serious postoperative complications. Postoperative CT examination should be used routinely to guide the surgeon to develop a more individualized treatment plan.