动力髋内固定治疗老年人非稳定型股骨粗隆间骨折体会.docVIP

动力髋内固定治疗老年人非稳定型股骨粗隆间骨折体会[摘要] 目的:探讨动力髋内固定治疗老年人非稳定型股骨粗隆间骨折的疗效。方法:对32例非稳定型股骨粗隆间骨折老年患者的临床资料进行回顾性分析。结果:对本组患者随访6～12个月,除3例患者死于内科疾病及其并发症外,余所有患者预后良好。根据黄公怡临床评价标准,本组患者中,优22例,良5例,可2例,优良率为90.6%。结论:应用动力髋内固定治疗老年人非稳定型股骨粗隆间骨折,骨折复位好,实用,可靠,效果理想。 [关键词] 动力髋内固定;非稳定型股骨粗隆间骨折;老年人 [中图分类号] R683.4 [文献标识码]B[文章编号]1673-7210(2010)05(a)-223-02 Experiences of dynamic hip internal fixation in elderly patients with unstable intertrochanteric femoral fracture ZENG Wei, LIN Sun, NING Jianwen (The First Surgical Department, the People’s Hospital of Wuchuan City, Guangdong Province, Wuchuan 524500, China) [Abstract] Objective: To explore the effects of dynamic hip internal fixation in elderly patients with unstable intertrochanteric femoral fracture. Methods: The clinical data of 32 cases with unstable intertrochanteric femoral fracture in elderly patients were analyzed retrospectively. Results: The patients in this group were followed up for 8-12 months, in addition to 3 patients died of medical illness and its complications, more than a good prognosis for all patients clinical evaluation criteria according to Huang Gongyi, In this group, 22 cases of excellent, 5 cases of good results, 2 cases of fair results, the excellent and good rate was 90.6%. Conclusion: Dynamic hip internal fixation in elderly patients with unstable intertrochanteric femoral fracture, fracture reduction is good, practical, reliable and satisfactory results. [Key words] Dynamic hip internal fixation; Unstable intertrochanteric femoral fracture; Elderly 股骨粗隆间骨折为老年人常见损伤,由于股骨粗隆部位本身的解剖特点及周围丰富的血运,所以骨折后易愈合,但易发生髋内翻,由于老年人本身的特点,长期卧床引起较多的并发症[1]。股骨粗隆间骨折分为稳定型和非稳定型骨折,而非稳定型股骨粗隆间骨折临床上治疗首选手术治疗,且尚无统一定型的内固定材料[2]。2006年10月～2008年10月,我院共收治32例老年非稳定型股骨粗隆间骨折,均应用动力髋内固定进行治疗,效果理想,现将相关情况报道如下: 1 资料与方法 1.1 一般资料 本组32例患者,男19例,女13例;年龄56～80,平均69.6岁。其中,跌伤患者26例,撞伤患者5例,压砸伤1例。根据Tronzo分类,Ⅲ型23例,Ⅳ型9例。患者合并高血压者15例,合并糖尿病患者8例,合并心脑血管疾病患者12例。 1.2 手术过程 术前行腰硬联合麻醉或者行硬膜外麻醉,在骨科牵引床做好牵引,于C臂X线机透视下进行手术。患者取仰卧位,于患侧股骨大粗隆外侧行纵行直切口,复位骨折,如有粉碎性骨块,必要时可用可吸收钉固