老年人转子间骨折46例治疗分析

目的探讨老年人转子间骨折治疗方式选择及疗效分析。方法2005～2011年，本院收治46例老年转子间骨折患者，根据患者自身条件及骨折分型不同，选择人工股骨头置换术、动力髋螺钉固定术、股骨近端交锁髓内钉内同定术3种不同手术方式，术中均应用C型臂透视。术后成功随访。结果46例患者，平均随访16个月（12～24个月），术后1、3、6、12、24个月接受X线检查，其中，接受关节置换患者22例，术后12个月功能评定优良率为91％（20／22）；接受动力髋螺钉内同定术16例，优良率为75％（12／16），骨折愈合率为94％（15／16）；接受股骨近端交锁髓内钉内固定术8例，优良率为75％（6／8），骨折全部愈合。结论老年股骨颈骨折患者多合并骨质疏松及其他内科疾病，综合考虑患者自身条件、选择合理的治疗方案是手术成功的前提保障。

Analysis of the treatment of interrochanteric fracture in 46 elderly patients

Objective To study the selection of treatments for interrochanteric fracture in elderly patients and curative effect. Methods From 2005 to 2011, 46 elderly patients with interrochanteric fracture accepting operation in our hospital were selected. According to patients’ conditions and fracture classification, three different treatments included artificial femoral head replacement, DHS and PFN. C-arm fluoroscopic intensifier were used during operation. All patients were followed-up. Results Forty six cases were followed up for 12 to 24 months with a mean of 16 months. X-ray examination was performed at 1, 3, 6, 12, 24 month after operation. 22 cases in all patients accepted artificial femoral head replacement, at 12 months after operation, the satisfactory rate reached to 91% (21/22). 16 cases accepted DHS, at 12 months after operation, the satisfactory rate was 75% (12/16) and the healing rate was 94% (15/16). 8 cases accepted PFN, at 12 months after operation, the satisfactory rate was 75% (6/8) and the healing rate was 100%. Conclusion Elderly patients of interrochanteric fracture often complicated with internal medicine diseases and osteoporosis. It is important to choose reasonable treatment according to patients’ conditions to make operation succeed.