老年股骨粗隆间骨折的手术治疗

Operative treatment of senile intertrochanteric fractures

目的探讨老年股骨粗隆间骨折患者术前合并症、术后并发症的预防处理,手术方式及临床疗效。方法手术采用有限切开、复位固定、假体置换治疗老年股骨粗隆间骨折43例。结果术中输血12例,平均输血400ml。术后14～35d可扶拐负重行走。43例获随访4～48个月,骨折临床愈合时间平均为4.6个月。按Harris评分标准:优14例,良23例,可6例,优良率达86.0%。无并发症发生。结论手术采用有限切开复位内固定,假体置换治疗老年股骨粗隆间骨折是一种较好的治疗方法,具有早期下地活动训练,功能恢复好,提高生活质量,疗效满意。

Objective To investigate the methods and results for the operative treatment of elderly patients with intertrochanteric fractures and to evaluate the efficiency of preventing complications of operations. Method 43 patients with intertrochanterie fractures were treated with incising limitedly, reduction and fixation, hip arthroplasty. According to the AO classification,there were 8 patienis with A1,12 cases with A2 and 23 cases with A3. In these patients, 18 patients were fixed with DHS,8 patients with screws, 11 patients with hip compress screws ,4 patients received bipolar femoral head replacement and 2 patients total hip arthroplasty. Results All patients accepted an average of 400ml blood transfusion during the operation. Patients got out of the bed after 14 - 35days. Forty-three patients were followed up for 4 - 48 months. The fracture healing time was 4.6 months. According to Hams rating scale： the excellent result was achieved in 14 cases ,good in 23 cases and fair in 6 eases,the ratio of the excellent and good results was 86.0%. No complication was found. Conclusion It＇ s an effective method to treat intertroehanterie fraetures in elderly patients with the limited incising reduction and internal fixation, prosthelic replacement. It＇ s advantages are earlier-weight bearing , better recovery of the hip function and improving the life quality.