髓外固定治疗老年股骨转子间骨折疗效

目的分析使用4种手术方法治疗老年股骨转子间骨折的疗效,探讨最佳治疗方案。方法 226例老年股骨转子间骨折患者分别采用空心加压螺钉(A组,47例)、外固定(B组,53例)、动力髋螺钉(DHS,C组,59例)、锁定接骨板(D组,67例)治疗。结果患者均获随访,时间9～24(18±2)个月。按黄公怡临床评定标准评价优良率:A组80.8%,B组81.1%,C组83.1%,D组94.0%。D组优良率最高,与其它3组比较差异有统计学意义(P<0.05)。结论 4种方式疗效均满意,但在综合考虑患者病情、骨骼质量、骨折类型和内固定材料特点之后,髓外固定治疗老年股骨转子间骨折的手术方案应首选锁定接骨板。

Evaluation of extramedullary fixation methods in treatment for eldly femoral intertrochanteric fracture

Objective To determine the optimal treatment of femoral intertrochanteric fracture by comparing 4 kinds of methods.Methods 226 cases of elderly patients with intertrochanteric fracture were divided into cannulated screws group(Group A,47 cases),unilateral external fixation group(Group B,53 cases),dynamic hip screw fixation system(DHS) group(Group C,59 cases),locking plate group(Group D,67 cases).Results 226 cases of patients were followed up for 9 ～ 24 months(average 18 months).The outcome was evaluated according to Huang Gong-yi’s criteria,the excellent and good rate of group A,B,C,D was 80.8%,81.1%,83.1%,94.0%,respectively.The excellent and good rate of Group D was significantly higher than Group A,B,C(P < 0.05).Conclusions The four kinds of methods all have good effect for femoral intertrochanteric fracture.The locking plate is the preferred extramedullary fixation method in treatment intertrochanteric fractures of eldly.