动力髋螺钉与股骨近端锁定板治疗高龄粗隆间骨折的疗效分析.docVIP

动力髋螺钉与股骨近端锁定钢板治疗高龄粗隆间骨折的疗效分析 严清理 张本其 桂春生 （安徽省池州市第二人民医院骨科，安徽 池州 247000） 摘要 背景：动力髋螺钉一度被认为是治疗股骨粗隆间骨折的“金标准”，随着内固定的发展，固定粗隆间骨折的方式有多种，另外一种临床多用的是股骨近端锁定钢板。 目的：评价动力髋螺钉（DHS）与股骨近端锁定钢板治疗高龄股骨粗隆间骨折患者的临床疗效。 方法：总结我科自2007-5/2012-5收治的65岁以上高龄股骨粗隆间骨折患者共45例，随机采用动力髋螺钉与股骨近端锁定钢板手术治疗。按照Evans分型方法进行骨折分型，分析两组病人手术失血量、手术时间、切口长度及术后并发症、关节功能恢复情况。 结果与结论：DHS组与锁定钢板组临床疗效的优良率分别为80.6%、81.4%,两组手术时间、切口长度以及失血量统计学无显著差异（P0.05)。但锁定钢板组手术时间、失血量较DHS组有减少趋势。随着手术技术与技巧的改进，DHS和股骨近端锁定钢板治疗高龄股骨粗隆间骨折，后者较前者在获得即刻稳定与远期并发症方面具有更好的优势，且在高龄骨质疏松患者中更明显。 关键词：粗隆间 骨折 高龄 动力髋螺钉 近端锁定钢板 骨质疏松 Dynamic Hip Screw Vs Locking Compression Plate For Treatment Of Intertrochanteric Fractures In Elderly Patients YAN Qing--li, ZHANG Ben-qi, GUI Chun-sheng(Orthopaedic the 2th Hospital,Chizhou Anhui China） Abstract: Background: Dynamic hip screw has been supposed to be the gold standard for treatment of intertrochanteric fractures, with the development of internal fixation，there are large numbers of methods to fix intertrochanteric fractures, another internal fixation is Locking Compression Plate, which is widely used in clinical. Objective: To evealuate the short-term outcome of DHS and Locking Compression Plate in the treatment of intertrochanteric fractures due to trauma for theication Old--years Patients. Methods: A total of 45 patients with intertrochanteric fractures were randomly divided into DHS group and Locking Compression Plate group during May-2007 to May-2012. The fractures were divded according to Evans Classfication. The intra-operative blood loss, operation time, lenth of incision, and post-operation complications were analyzed. Results and Conclusion: The excellent and good rates of patient outcomes in DHS Group and Locking Compression Plate Group were 80.6% and 81.4%.Respectively (P0.05). Although the operation time and blood loss had a decreasing tendency in the Locking Plate group. Conclution With the maturation of technique, DHS and Locking Compression Plate have similar efficacies in