不同固定方法治疗老年股骨转子间骨折

Different operative methods intertrochanteric fracture in elderly patients

目的 探讨不同固定方法早期手术治疗老年股骨转子间骨折的疗效。方法 早期采用不同固定方法治疗老年股骨转子间各型骨折 15 0例 ,早期锻炼 ,延迟负重。结果 随访 14 0例 (93 3% )。随访时间 6～36个月 ,平均 2 0个月。围手术期无严重并发症发生 ,切口无感染 ,骨折均愈合 ,骨愈合时间 3～ 8个月 ,平均4 5个月。按黄公怡功能标准评定 :优 12 8例 (91 4 % ) ,良 9例 (6 4 % ) ,可 3例 (2 2 % )。结论 根据老年患者状况和转子间骨折类型选择不同固定方法 ,早期手术 ,合理锻炼 ,可有效减少各种并发症 ,降低病残率。

Objective To evaluate the effects of different operative methods for elderly patients with intertrochanteric fracture of femur. Methods 150 elderly patients with different types fractures were operated early by different fixation measures. All were performed early exercises but delayed weight bearing. Results 140 cases (93.3%)were followed up for 6 to 36 months (average 20 months). No patient had systemic complication in perioperative period, and no infection was found. Fracture got union during 3 months to 8 months (average 4.5 months). According to the criteria of Huang Gongyi Functional Standards, the results were excellent in 128 cases(91.4%), good in 9 cases(6.4%), and fair in 3 cases (2.2%) in the patients who were followed up. Conclusion Different fixation measures should be selected to use according to general circumstances and the types of intertrochanteric fracture for the elderly patients. Early operation and rational exercise can prevent complications and reduce mobidity.