加压螺钉治疗老年股骨转子间骨折的临床与X线分析

目的：探讨髋动力加压螺钉（ＤＨＳ）治疗老年股骨转子间骨折中的影响因素及操作技术。方法：临床应用３８例，男２３例，女１５例，平均年龄６２３岁。其中稳定型骨折１６例，不稳定型骨折２２例。随访７～３０个月，平均９个月。结果：髋关节功能根据ＭｅｒｌｅＤＡｕｂｉｇｎｅ评分方法，优２３例（１７～１８分），良１１例（１３～１６分），差４例（８分）。结论：ＤＨＳ治疗老年股骨转子骨折的疗效与小转子区骨折块的解剖复位、加压螺钉的位置及股骨近端的Ｓｉｎｇｈ指数等因素密切相关；加压螺纹钉的理想位置应该是Ｘ线正位像上在偏内下方，侧位像上在中央。

Clinical and Xray Analysis of Dynamic Hip Screw for Treatment of Intertrochanteric Fracture of the Femur

Objective:To discuss the influence factors and operative technique of dynamic hip screw (DHS) in treatment of intertrochanteric fracture of femur in aged person.Method:Among the 38 cases treated with DHS,23 cases were male,15 cases were female.Average age of all cases was 623 years.16 cases had a stable fractures.22 cases had unstable fractures.All cases were followed up for 730 months with an average of 9 months.Result:Functional evaluation of hip joint was based on Merleds Aubigne grading method.23 cases were excellent (1718 scores),11 cases were good(1316 scores),4 cases were poor(<8 scores).Conclusion:The curative outcome of operation for intertrochanteric fracture of the femur in aged person is concerned with anatomical reduction of lesser trochanter,position of screw,Singhs index of proximal femur.The ideal position of the screw should be slightly medial and inferior to the femoral neck in posterioranterior Xray film,central in lateral film.