国产重建钉治疗老年股骨粗隆间骨折_临床医学论文.docVIP

国产重建钉治疗老年股骨粗隆间骨折_临床医学论文 国产重建钉治疗老年股骨粗隆间骨折_临床医学论文 作者：牛云峰，刘金榜，闫伟，秦本刚，郑永红 【关键词】 股骨粗隆间骨折；,,重建钉；,,并发症 　　摘要：目的：探讨国产重建钉治疗老年人股骨粗隆间骨折的临床效果和并发症。方法：自2001年3月到2005年5月，采用重建钉治疗46例老年股骨粗隆间骨折患者，平均随访12个月，观察疗效。结果：2例(4.3%)术中复位不良，无术中股骨近段骨折发生，随访9～30个月后，无远端锁钉处骨折发生，6例(13%)患者发生髋内翻，其中4例(8.7%)近端拉力螺钉切割股骨头，1例近端拉力螺钉退出，1例为术中复位不良者。另有1例单纯近端拉力螺钉退出不合并髋内翻。余40(87%)例骨折愈合良好，髋关节活动良好。结论：国产重建钉治疗老年股骨粗隆间骨折，术中并发症少见，更易完成手术，但远期髋内翻发生率高，不能令人满意。 　　关键词： 股骨粗隆间骨折； 重建钉； 并发症 　　Reconstruction Nail for Intertrochanteric Fractures in Older Patients 　　Abstract： Objective: To investigate the clinical results and the complication of intertrochanteric fractures in older patients with reconstruction intramedullary nail. Method: From 2001 to 2005, 46 consecutive cases with intertrochanteric fractures managed with the reconstruction intramedullary nail were enrolled in this study. The average follow-up period was 12 months. Result: The reduction was no-satisfaction in 2 cases(4.3%), and no case of intraoperative trochanteric extension of the fracture complications. Follow 9-30 months, postoperative fracture of the femoral shaft was not encountered with the group. But there were 6 varus deformities(13%), include 4cases(8.7%) with lag-screws cut-out and 1 with lag-screws pull-out,1 of not-well reduction. There was 1 case with lag-screws pull-out without varus deformity. 40 patients(87%) have good union of fracture and weel function of hip include 1 with not-well reduction. Conclusion: The trial showed that the intraoperative complication rate with reconstruction intramedullary nail fixation was so lower and the operative technique was easy. But the rate of varus deformity was unsatisfactorily. 　　Key words： Intertrochanteric fracture; Reconstruction nail; Complication 　　股骨粗隆间骨折多见于老年人，常常合并骨质疏松及其他内科疾患。随着近年髓内固定的发展，多种股骨髓内针用于髋部的骨折，但名称繁多，多家报告结论不一。本院自2001年3月到2005年5月应用国产股骨重建钉治疗46例老年股骨粗隆间骨折，回顾分析其临床效果和并发症。 　　1 材料和方法 　　1.1 一般资料：本组46例，其中男30例，女16例，男女比1.88：1；年龄65～91岁，平均73岁；低能量伤（跌坐伤）36例，交通伤10例；Evan’s分型［1］Ⅰ度6例，Ⅱ度5例，Ⅲ度16例，Ⅳ度9例，Ⅱ型10例。 　　1.2 国产重建钉：主钉直径分