手术治疗老年股骨转子间骨折66例体会

目的总结采用不同固定方式治疗老年转子间骨折的临床疗效。方法手术治疗老年转子间骨折66例,其中成角进针外固定支架固定18例,动力髋螺钉固定32例,股骨重建钉固定16例。结果66例平均随访2(1~8)年,骨折均愈合,愈合时间平均5(4~7)个月。针孔感染2例,经换药痊愈,股骨颈轻度短缩畸形2例,未予处理。术后功能评价:优37例,良23例,可5例,差1例。无骨不连或延迟愈合病例,无骨折愈合前死亡病例,功能优良率:外固定架治疗组为83.3%,动力髋螺钉治疗组为90.6%,股骨重建钉治疗组为100%。结论正确的围手术期处理是老年转子间骨折手术治疗的安全保障;应根据患者的全身情况及骨折类型选择固定的方式。

Surgical Treatment for Femoral Intertrochanteric Fracture in 66 Elder Patients

Objective To review and evaluate the effectiveness of a variety of surgical treatment for femoral intertrochanteric fracture in the elder cases.Method 66 cases underwent surgical treatment including angulated insertion external fixation in 18 cases,dynamic hip screw(DHS) in 32 cases and interlocking nail fixation in 16 cases.Results No bone nonunion,delayed union or perioperative death occurred in 1 to 8 years follow-up.There were 2 cases of pin tract infection and 2 of femoral calcar shorten,which were free of special treatment.Postoperative function evaluation showed 37 excellent,23 good,5 fair and 1 poor.The excellent and good rate was 83.3% for cases underwent angulated insertion external fixation,90.6% for DHS,100% for interlocking nail fixation.Conclusion Individualized procedure determination is critical for the femoral intertrochanteric fracture in elder,based on the general condition and characteristics of fracture.