股骨近端外侧加压锁定板内固定治疗高龄患者股骨粗隆间骨折34例报告.docxVIP

股骨近端外侧加压锁定板内固定治疗高 龄患者股骨粗隆间骨折34例报告 李裕标郭乃铭徐海涛罗筱玮黄梦全赖秋练 广州解放军第458医院骨科 摘要： 口的探讨骨折部植骨、股骨近端外侧加压锁定板内固定治疗高龄股骨粗隆间骨 折患者的疗效。方法 对20 1 320 1 5年我院收治的34例高龄股骨粗隆间骨折患者, 采用骨折部植骨、股骨近端外侧加压锁定板内固定进行治疗。对骨折愈合、并发 症、关节功能等指标进行统计观察。结果本组均获个月随访，3例分别于术 后1个月、4个月和6个月因肺部感染死亡，29例骨折愈合，2例骨折不愈合。 Harris 关节评分系统评分$90分13例，7090分15例，40?分3例，平均 (81.3±5, 4)分。结论采用骨折部植骨，股骨近端外侧加压锁定板内固定的方 法治疗高龄股骨粗隆间骨折，临床疗效良好。重视合并症的治疗，有效防范严重 并发症的发牛，保证手术安全，有效降低围手术期及术后病死率。 关键词： 股骨粗隆间骨折;股骨锁定钢板;高龄;内固定;植骨; 收稿日期：2016-12-03 Clinical effects on senile pa/tients with femoral intertrochanteric fractures: report of 34 cases LI Yu-biao GUO Nai-ming XU Hai—tao LUO Xiao-wei HUANG Meng-quan LAI QiuTian Depar tment of Ort hopaedics, PLA 458th Hosp it al: Abstract： Objective To investigate clinical effects of locking proximal femoral plate ( LPFP) with bone grafting for femoral intertrochanteric fracture in elderly patients. Methods Thirty-four patients with femoral intertrochanteric fractures, treated with LPFP and bone grafting, were retrospcctivc analyzed. Fracturc healing time, surgical compliedtions and joint function recovery were observed. Results All patients got regular follow-up from 1 to 24 months. Three patients died of lung infections at 1, 4, 6 months postoperatively. Twenty-nine patients got clinical healing, while nonunion occurred in 2 paXients. Harris score: 290 in 13 patients，70-90 in 15 paticnts, 40-70 in 3 patients, on average (81. 3 ± 5. 4) ? Conclusions LPFP with bone grafting is effective in the treatment of femoral intertrochanteric fracture in elderly patients. Management of complications should be emphasized to lower the mortality rate perioperatively and postoperatively. Keyword： Femoral intertrochanteric fracture; Locking proximal femoral plate; Sen订e patients; Internal fixation; Bone grafting; Received： 2016-12-03 老年股骨粗隆间骨折在创伤骨科中较为常见，随着社会老龄化进程的加快，其 发病率逐渐升高。高龄患者身体状况差，脏器功能弱，合并疾病多，长期卧床导 致并发症的发生，病死率高LQ,目前早期手术治疗并进行术后功能锻炼是治疗 老年股骨粗隆间骨折的首选治疗方法［2-3］。由于该类患者骨折局部骨量少、骨 质疏松严重，如何保证良好的骨折复位，坚强内固定，避免魏内翻、头内切割等 导致的手术失败，骨科医师应谨慎选择固定方法。笔者对2013