股骨粗隆间骨折手术方法的探讨

目的：探讨不同手术固定方法治疗股骨粗隆间骨折的疗效。方法：本组纳入股骨粗隆间骨折患者169例，其中48例合并有内科疾病，占28．4％。分别采用动力髋螺钉（DHS）79例、三枚空心加压螺钉（3CS）43例、动力髁螺钉（DCS）32例和股骨近端髓内钉（PFN）15例治疗，结合早期功能练习，观察骨折愈合时间及不良反应发生情况。结果：随访率100％，随访时间6～18个月。骨折均愈合，骨愈合3-8个月。除2例肢体短缩外，无髋内翻畸形、感染、钉断裂、退钉。结论：根据股骨粗隆间骨折稳定程度．患者年龄，一般状态和有无合并内科疾病，选择不同固定方法，可降低髋内翻等并发症及病残死率。

Surgical experience of the femoral intertrochanteric fractures

Objective:To discuss the efficacy of different surgical fixations on the femoral intertrochanteric fractures.Methods:From Feb.1998 to Aug.2007,169 patients with the femoral intertrochanteric fractures were surgically treated.Among them,there were 76 male and 93 female patients,and the age range varied from 35 to 87 years (the average age was 61 years).48 patients (about 28.4%) of all accompanied by other internal medical disorders.the treatment of 79 patients was selected with DHS,43 patients with 3CS,32 patients with DCS,15 patients with PFN. All patients did dirigation early.Results:All patients were followed up for 6 to 18 months post-operations.The fractures of all patients with femoral intertrochanteric fractures were healed between 3 to 8 months after operation.Meanwhile,except 2 shortening of lower extremity parients,there were no complications occurred:such as coxa vara,infections,break of nails,or withdraw of nails. Conclusion:Different fixation methods should be applied according to the stability of fracture,general state and medical complications of senile patients,which can reduce the incidence of complications,invalidity and fatality,such as coxa vara and so on.