摘要
目的:总结高龄股骨粗隆间骨折的治疗经验,分析组合式外固定架和解剖钢板固定的临床疗效。方法:2006年10月至2009年6月,股骨粗隆间骨折42例,其中组合式外固定架治疗(组合式外固定架组)19例,男7例,女12例;年龄71～103岁;骨折按Evans分型,Ⅰ型3例,Ⅱ型5例,Ⅲ型6例,Ⅳ型5例。解剖钢板治疗(解剖钢板组)23例,男9例,女14例;年龄73～97岁;骨折分型,Ⅰ型5例,Ⅱ型4例,Ⅲ型10例,Ⅳ型2例,V型2例。对两组手术时间、术中出血量、住院时间、下地负重时间、骨折愈合时间及治疗效果等进行比较,并做统计分析。结果:所有病例均获随访,时间6～15个月,平均8.6个月。组合式外固定组手术时间平均(29.368±3.253)min,术中出血量平均(30.526±5.243)ml,住院时间平均(4.368±1.165)d,下地负重时间平均(14.526±1.867)周,骨折愈合时间平均(14.632±2.798)周;而解剖钢板组上述指标分别为(58.987±8.600)min,(256.090±30.112)ml,(13.783±1.976)d,(11.391±1.644)周,(11.391±2.327)周;两组比较,差异均有统计学意义(P<0.05)。Harris评分,组合式外固定架组平均(86.368±3.640)分,而解剖钢板组(86.435±4.198)分,两组比较,差异无统计学意义(P>0.05)。结论:组合式外固定架与解剖钢板治疗高龄股骨粗隆间骨折均可获得满意疗效,组合式外固定架操作简便、手术损伤小,更适合于身体条件较差而不能耐受较大手术的患者。
Objective：To summarize the therapeutic experience and analyse the clinical effects of anatomical plate and combined external fixator for the treatment of elderly intertrochanteric hip fractures. Methods：From Oct.2006 to Jun.2009,42 patients with intertrochanteric hip fractures were treated. Among them, 19 patients were treated with combined external fixator, included 7 males and 12 females, aged from 71 to 103 years old;according to Evans classification, there were 3 of type I, 5 of type II ,6 of type III ,5 of type IV. The other 23 patients were treated with anatomical plate ,included 9 males and 14 females, aged from 73 to 97 years old; there were 5 of type I , 4 of type II , 10 of type II , 2 of type IV, 2 of type V. Comparisons and statistical analysis were made on operation time, blood loss during operation, hospitalization time, the time of loaded walking, fracture healing time and therapeutic effect. Results：All the patients were followed up for 6 to 15 months with an average of 8.6 months. In combined external fixator group, the average operation time was （29.368±3.253） min, the average blood loss during operation was （30.526±5.242） ml, the average hospitalization time was （4.368±1.165 ） d,the average time of loaded walking was （14.526±1.867）weeks,the fracture healing time was （14.632±2.798） weeks;in the anatomical plate group above-mentioned indexs were （58.987±8.600） rain, （256.090±30.112） ml, （13.783±1.976） d, （11.391±1.644） weeks, （11.391±2.327） weeks, respectively; and there were significant differences between two groups （P〈0.05）. According to Harris score criterion, the scores of combined external fixator group was （86.368 0±3.640） scores,and the scores of anatomical plate group was （86.435±4.198） scores;there were no significant differences between two groups （P〉0.05）. Conclusion：The effect of combined external fixator and anatomical plate for the elderly intertroehanteric hip fractures are both satisfactory and each has its own merits. Combined external fixator has advantages such as fewer complications and operative injuries than that of anatomical plate and is more suitable for the weaker with elderly intertrochanteric hip fractures.
出处
《中国骨伤》
CAS
2011年第5期374-377,共4页
China Journal of Orthopaedics and Traumatology
关键词
股骨骨折
髋骨折
骨折固定术
老年人
临床对照试验
Femoral fractures
Hip fractures
Fracture fixation
Aged
Controlled clinical trials
