Richard钉内固定术治疗股骨转子间骨折84例临床观察

CLINICAL OBSERVATION ON 84 CASES OF TROCHANTERIC FRACTURE TREATED BY INTERNAL FIXATION WITH RICHARD PIN

目的：探讨Ｒｉｃｈａｒｄ钉内固定术治疗股骨转子间骨折。方法：回顾分析近３年应用Ｒｉｃｈａｒｄ钉内固定术治疗股骨转子间骨折８４例的方法及疗效。结果：随访７１例，疗效：优５５例，良１６例，优良率达１００％。结论：（１）对股骨转子间骨折并存有心血管等疾患者，术前积极处理、术中术后严密观察，Ｒｉｃｈａｒｄ钉内固定术是可行的。（２）手术时机：老年患者且无并存症入院后４～５天，中青年牵引１周后为宜。（３）Ｒｉｃｈａｒｄ钉固定后，不须加一螺丝钉以控制旋转。（４）术后不须骨牵引，可较早扶拐离床活动。（５）Ｒｉｃｈａｒｄ钉内固定术是治疗股骨转子间骨折有效方法。

OBJECTIVE: To study the technique of internal fixation with Richard Pin to treat trochanteric fracture. METHOD: Data of 84 cases hospitalized in the recent three years has been reviewed and analysed. RESULTS: During follow-up, 55 of 71 cases received excellent result and 16 good result. CONCLUSIONS: (1) careful observation and management is necessary for patients in case of complicating cardiovascular disease; (2) Operation time: the 4-5th day after hospitalization for old patient without complication and one week traction preoperatively is necessary for young and middle-age patient; (3) a screw is unnecessary to control retation; (4) Traction is unnecessary postoperatively, but patient can early exercise with a stick; (5) Internal fixation with Richad Pin is a effective therapy for trochanteric fracture.