老年股骨粗隆间骨质疏松性骨折外固定术

目的探讨股骨粗隆间骨质疏松性骨折术式的选择和外固定术的可行性,扩大其治疗范围。方法闭合复位,股骨头颈内交叉穿入3枚斯氏针,股骨近段穿入2枚螺纹半针并组合成不规则四边形固定。结果经平均16·3个月的随访,本组25例无脱针、股骨头切割、继发髋内翻等病例,无严重的针道感染,骨折愈合良好。结论骨外固定术具有创伤小、出血少、手术时间短、操作简单等优点,结合头颈内交叉穿针不仅提高了固定的可靠性,而且对伴有骨质疏松的股骨粗隆间骨折具有较好固定作用,尤其对不能耐受内固定术的高龄患者有一定优势。

Treatment of Femoral Intertrochanteric Fractures with Osteoporosis by External Fixation for Senile Patients

Objective To investigate the best surgical procedure and the feasibility of external fixation for femoral intertrochanteric fractures in osteoporotic patients and to extend the range of the treatments.Methods Closed reduction and three intersectional Steinmann pins were inserted into the head and neck of femur with two semi-spiral pins into the proximal femur to make an irregular quadrangle.Results Twenty-five patients were followed-up with the average of 16.3 months.No broken pin, falling-off pin,femoral head cut,secondary varus malalignment or uncontrollable pin-tract infections occurred. Conclusion Skeletal external fixation has the advantages of less bleeding, short operating time and simple operation. The mode of crossed pins improves the reliability of the fixation and produces a better fixation for intertrochanteric fractures with osteoporosis. It's especially good for senile patients who are not able to tolerate internal fixation.