Richard钉内固定治疗老年粗隆间骨折手术并发症原因分析

Analysis on the complications after treatment of intertrochanteric fracture with Richard screw fixation

目的探讨Richard钉内固定治疗老年股骨粗隆间骨折手术并发症的原因。方法回顾Richard钉内固定治疗老年粗隆间骨折146例临床资料,分析其中25例手术并发症的相关因素。结果加压钉位置不良9例,髋内翻7例,Richard钉板松动3例,深部血肿、脂肪液化、局部骨吸收各2例。手术并发症相关因素还包括年龄、骨质量、骨折程度、手术适应证选择、手术技术等。结论骨质疏松、骨折局部骨缺损是老年粗隆间骨折主要病理特征。选择Richard钉内固定须注意患者年龄、骨折类型、骨质量等。手术技术的优劣是避免手术并发症决定性因素。

Objective: To analyze the relative factors of the surgical complications after the treatment of the femoral intertrochanteric fracture(FIF) with Richard screw internal fixation.Method:The clinical materials of 146 cases of FIF treated with Richard screw fixation were collected,and surgical complications of 25 cases were analyzed retrospectively.Result: Various complications were found from the investigation,such as: 9 cases of screw mal-position,7 cases of coxa vara,3 cases of screw loosening,2 cases of deep hemotoma,2 cases of fat dissolution and 2 cases of bone resorption.The reasons and relative factors of the complications included patient' age,bone quality,fracture severity,surgical indication and surgical skill,etc.Conclusion:The osteoporosis and the bone defect near the fracture area are main pathological features of FIF.Considerations about the patient age,the fracture type and the bone quality should be taken seriously.The surgical skill is the decisive factor for avoiding surgical complications.