早期小切口重建钉内固定治疗老年股骨粗隆间骨折

目的探讨股骨重建钉治疗老年股骨粗隆间骨折的疗效。方法2001年6月~2005年10月,采用闭合复位小切口股骨重建钉固定治疗老年股骨粗隆间骨折患者58例,均在伤后1周内施行手术,手术采用C型臂X线机透视下闭合复位,小切口将股骨重建钉置入,观察术后疗效并对该治疗方法进行评价。结果58例术后随访8~22个月,平均13.6个月。3例术后3个月股骨颈拉力钉脱出(行钉道充填骨水泥后重新固定),1例发生骨化性肌炎,2例发生髋内翻,无心、脑栓塞和坠积性肺炎发生;58例骨折均愈合,骨折愈合时间(15±5)周;按黄公怡评价标准,术后髋关节功能恢复优良率达91.6%。结论闭合复位小切口股骨重建钉固定治疗股骨粗隆间骨折,具有手术时间短、出血少且固定牢靠的优点,适用于老年股骨粗隆间骨折的治疗。

Small incision operative treatment of intertrochanteric fractures in the elderly with reconstruction nails

Objective To study the treatment results of intertrochanteric fractures in the elderly with the femoral reconstruction nails.Methods A total of 58 cases of elderly intertrochanteric fractures were treated with the femoral reconstruction nails from June 2001 to October 2005.All operations were completed with a means of close reduction of the X-ray and small incision in one week post-traumatic.Results The follow-up ranged 8～22 months,average 13.6 months,showed 58 cases gained bone union in(15±5)weeks.Three cases were found tensile force nails exiting in 3 months post-operative,2 cases varus hip and 1 case ossifying myositis.According to the standard of Huang Gongyi,the rate of excellent and good was 91.6%.Conclusion Small incision operative treatmeant of intertrochanteric fractures with reconstruction nails is an effective means for the elderly for its short operation time,little bleedling and firm fixation.