老年股骨转子间骨折内固定失效的原因及对策概念.doc

老年股骨转子间骨折内固定失效的原因分析及对策 湖北医药学院附属襄阳医院骨科 刘江涛 邱晨 徐俊昌 刘涛 贾吉光 王永贵 常增林 【摘要】【目的】分析老年股骨转子间骨折内固定失效的原因，并研究其对策。【方法】回顾分析相关文献457篇,报道病例数27380例，内固定失效病例数394例。回顾我院自2006年7月-2011年6月老年股骨转子间骨折手术病例268例,统计内固定方式,回访并分析手术后2年的内固定失效情况。【结果】文献报道27380例,内固定物包括: PFN, PFNA, DHS, DCS, γ钉, 锁定钢板等,内固定失效病例数394例。我院临床病例数268例,内固定物包括: PFN, PFNA, DHS, 锁定钢板等,失效病例数4例。【结论】导致老年股骨转子间骨折内固定失效存在内在因素和外在因素。制定个性化治疗方案以及康复计划是预防内固定失效的关键。 【关键词】：股骨转子间骨折 内固定 失效 原因分析 The failure reasons of trochanteric femoral fractures after internal fixation in the elderly and their countermeasures//Liu Jiang-tao, Qiu Cheng, Xu Junchang, et al. 【Abstract】 【Objective】To analysis the failure reasons of trochanteric femoral fractures after internal fixation in the elderly and their countermeasures. 【Methods】 We reviewed 457 related clinical reports, 27380 cases were reported, 394 cases of those failed. A retrospective study of 268 cases treated surgically from July 2006 to June 2011 in our hospital was made. In the study, the style of internal fixation was analysised. All cases were followed up for two year after operation, the failure cases of those were statisticsed.【Results】In the reported 27380 cases, the internal fixation included PFN, PFNA, DHS, DCS, γNail, Locking Plate, et al. 394 cases of those failed. The 268 cases in our hospital treated with PFN, PFNA, DHS, Locking Plate, 4 cases of those failed.【Conclusions】Leading to the failure of trochanteric femoral fractures after internal fixation in the elderly exists internal factors and external factors. The key preventing the internal fixation failure is making personalized treatment and rehabilitation plan. 【Key words】 trochanteric femoral fracture; internal fixation；failure 【Author’s address】 Orthopedic Department, XiangYang No:1 people’s Hospital, affiliated Hospital of Hubei University of Medicine, XiangYang, 440015,Hubei, China. 随着我国社会老龄化,老年股骨转子间骨折发病率越来越高,大多数学者主张手术治疗为主[1-3],以减少长期卧床导致的并发症,如坠积性肺炎、泌尿系感染、褥疮等。但治疗中仍然存在一些问题,包括内固定失效[4-7]。我们复习了2006年7月-2011年6月一些相关文献报道结合我院骨科临床工作实际,分析老年股骨转子间骨折内