高龄粗隆间骨折的微创治疗应用探讨

Analysis of Minimally Invasive Surgery for the Intertrochanteric Fractures in the Elderly

目的 探讨小切口微创技术治疗高龄股骨粗隆间骨折的方法及其疗效。方法 收集近2年来65岁以上高龄粗隆间骨折病例33例，其中小切口DHS治疗18例，微创Gamma钉治疗15例，对手术切口大小、操作时间、术中术后出血量、并发症、术后髋关节功能评定进行临床随访分析。结果 33例均得到随访，小切口DHS组：切口长度为4cm（3～5cm），平均手术时间70min（60～100min），平均出血100mL（50～200mL）；微创Gamma钉：切口长度为3cm（2．5～4．5cm），平均手术时间50min（40～70min），平均出血65mL（30～100mL）。对两组进行术后功能评定，优30例（90．9％），良3例（9．1％）。结论 小切口技术治疗股骨粗隆骨折创伤小，是高龄患者一种理想的治疗方法。

Objective To report the technique and clinical results of minimally invasive surgery for the in tertrochanteric fractures in the elderly. Methods 33 eases of over 65 years old who had been hospitalized and operat ed on in the last 2 years were included. 18 eases were operated with DHS through minimal incision while 15 eases with Gamma nail. Results In the I）HS through minimal incision group,the mean length of incision was 4 era（3 to 5 era）, the mean time of operation was 70 rain（60 to 10ff min）,the mean blood loss during operation was 100 mL（50 to 200 mL）;In the Gamma group：the mean length of incision was 3 era（2.5 to 4.5 cm）,the mean time of operation was 50min（40 to 70min） ,the mean blood loss during operation was 65 mL（30 to 100 mL）. All patients were evaluated with functional recovery. 30 eases obtained excellent results,and 3 good. Conclusion Minimal invasive surgery is one of the ideal choices for the treatment of intertrochanteric fractures in the elderly.