老年人股骨粗隆间骨折的手术治疗

Surgical Treatment of Intertrochanteric Fractures in Aged Patients

【目的】探讨老年人股骨粗隆间骨折的有效治疗方法。【方法】手术治疗60岁以上老年人股骨粗隆间骨折113例,其中动力髋(DHS)51例,Gamma钉36例,AO空心加压螺钉12例,解剖钢板6例,人工全髋关节置换8例。【结果】通过6个月至8年(平均39个月)随访,优良率为92.5%,并发症发生率为9.73%。【结论】手术治疗老年人粗隆间骨折存在风险,但较之保守治疗风险及并发症更低;只要围手术前期准备充分,采取有效措施治疗内科合并症,均能取得满意疗效;而术式选择与骨折类型密切相关。

[Objective]To evaluate the treatment and complications in aged patients with intertrochanteric fractures. [Methods]Totally 113 cases of intertrochanteric fracture in old persons over 60 years were operated. All of them had been followed up from 6 months to 8 years （mean 39 months）. [Results]The rate of excellent and good results was 92.5%, the rate of complications was 9.37%. [Conclusion]There are some risks in the operative treatment for intertrochanteric fractures in the elderly, however, if effective treatment of preoperative medical conditions and good postoperative care are provided, the overall therapeutic results are satisfactory with lower risk than conservative treatment. The operation model is bond up with fracture types.