摘要
目的探讨老年股骨粗隆间骨折的治疗方法及疗效。方法 2004年1月～2011年4月,收治老年股骨粗隆间骨折并有完整资料者142例。跌伤70例,摔伤45例,交通伤27例。骨折按Evans分型,Ⅰ型29例,Ⅱ型27例,Ⅲ型41例,Ⅳ型28例,Ⅴ型17例。合并心脑血管疾病88例,高血压81例,慢性支气管炎59例,糖尿病79例。姑息治疗56例,动力髋螺钉固定49例,股骨近端髓内钉固定37例。结果获得随访142例,随访时间1～8年,髋关节功能按Harris评分标准进行评价。姑息治疗平均住院时间51d,骨折平均愈合时间20周,发生不同程度髋内翻18例,优良40例,优良率71.4%。动力髋固定平均住院时间25d,骨折平均愈合时间16周,优良40例,优良率81.6%。股骨近端髓内钉固定平均住院时间19d,骨折平均愈合时间14周,优良32例,优良率86.4%。结论老年股骨粗隆间骨折,应根据患者全身状况和骨折类型选择个体化的治疗方案,积极手术治疗。
[ Abstract] Objective To investigate the treatment method of senile patients with femoral intertrochanteric fractures and its clinicoal outcomes. Methods From January 2004 to April 2011. 142. The injury was caused by fail on walking in 70 cases,fall whenriding a bicycle in 45 ,and traffic accidents in 27eases . According to Evans classification, there were29cases of type Ⅰ , 27cases of type Ⅱ ,41 cases of type Ⅲ,28 eases of type IV, 17 eases of type V. 88 patients were associated with cardio-cerebrovascu- lar diseases, 81patients were complieted with siabetes, Among those patients , 56were treated with conservative treatment , 49received dynamic hip screw fixation, and 37 underwent proximal femoral Gamma nail fixation. Results 142 patients were fol- lowed up for 1 ~ 8years. Harris score system was adopted to evaluate hip joint function, The conservative treatment group： the aver- age hospital stay length was 51 days; the average bone heal ing time was 20 weeks; 18 cases had different degrees of eoxa adducta; 40eases were graded as excellent, and as good. The excellent and good rate was 71.4%. dynamic hip screw fixation group： the aver- age hospital stay length was 25 days; the average bone heal ing time after operation was 16 weeks; dO cases were graded as excellent, and as good, The excellent and good rate was 81.6%. Gaamm lmil fixation group： the average the average hospital stay length was 19 days; the average bone heal ing time after operation was 14 weeks;32 eases were graded as excellent, and as good. The excellent and good rate was 86.4%. Conclusion For geriatric femoral intertrochanteric fractures, individual ～ oriented treatment methtxl should be selected on the basis of physical conditions of patients and the types of fractures, operative treatment should be performed.
出处
《四川医学》
CAS
2012年第12期2147-2149,共3页
Sichuan Medical Journal
关键词
股骨粗隆间骨折
股骨近端髓内钉
动力髋螺钉
姑息治疗
intertrochanteric
fracture
proximal femoral intramedullary nail
dynamic hip screw
internal fixation
conserva-tive treatment
