高龄股骨粗隆区骨折小创口改良复合内固定治疗的探讨

Treatment of better small wound combination internal fixation for intertrochanteric femoral fracture in the elderly

目的探讨高龄伴发各种全身疾病的股骨粗隆区骨折病人的手术治疗方法及相关影响因素。方法对37例伴发全身疾病的高龄股骨粗隆区骨折病人在严密的术前检查和评估后进行小切口切开复位动力髋螺钉（DHS）加拉力螺钉内固定术,其中,高血压病21例,中风后遗症3例,糖尿病13例,冠心病2例,心律失常8例,肺气肿2例,慢性支气管扩张5例,11例病人伴发2种全身疾病,6例伴发3种全身疾病。结果经过6个月～4年的随访,平均18个月,按莫子丹标准（术后关节活动度、疼痛及生活自理能力）评定,疗效优良率89.2%。结论小切口切开复位DHS加拉力螺钉内固定术是一种效果较好的治疗高龄股骨粗隆区骨折病人的方法。

Objective To study the treatment options and influential factors for intertrochanteric femoral fracture in elderly with various kinds disease.Methods Thirty-seven aged patients suffered various kinds internal disease intertrochanteric femoral fracture were treated with dynamic hip screw（DHS） add tensile force screw internal fixation,hypertensive disease 21 cases,blood-stroke sequela 3 cases,diabetes 13 cases,coronary heart disease 2 cases,heart rate aberration 8 cases,emphysema 2 cases,chronicity bronchiectasia 5 cases,11 cases suffered 2 types of morbus internus concomitantly,6 cases suffered 3 types of morbus internus concomitantly.Results All the patients were followed-up 6 months to 4 years（average 18 months）,according to Mozi-dan standard,the rate of excellent and good were 89.2%.Conclusion The small wound combination internal fixation is a good method to treat intertrochanteric fractures of old patitents.