应用微创手术动力髋螺钉治疗稳定型老年股骨转子间骨折

Applying minimally invasive surgery technology with DHS to treat senile stable femoral intertrochanteric fracture

目的探讨应用微创手术动力髋螺钉(DHS)固定治疗稳定型老年股骨转子间骨折的临床疗效及应用价值。方法采用闭合复位、经皮打入导针,动力髋滑动螺钉及钢板同时置入,切口长度根据皮肤弹性及皮下脂肪厚度决定的手术方法治疗稳定型老年股骨转子间骨折患者34例,了解手术情况并随访观察疗效。结果手术出血150～500ml,平均325ml;手术时间45～70min,平均57.5min;手术切口长度3～7cm。34例患者均获随访,随访时间8～26个月,平均14.8个月,无死亡病例。骨折愈合时间8～12周,平均8.9周。关节功能评价,优:25例,良:6例,可:2例,差:1例;优良率91.2%。结论此方法可确定手术切口位置及长度、手术创伤小、骨折愈合快、关节功能恢复良好,是治疗稳定型老年股骨转子间骨折的有效方法。

Objective To investigate the clinical effect and application value of using minimally invasive surgery technology with DHS to treat senile stable femoral intertrochanteric fracture. Methods 34 cases with senile stable femoral intertrochanteric fracture received the surgery by applying closed reduction, guiding pereutaneous needle, inserting dynamic hip screw sliding bolt and the plate at the same time. The length of incision was confirmed by the elasticity of skin and the thickness of subcutaneous fat. The situation of surgery and followup effect were observed. Results The hemorrhage was 150 -500 ml （average 325 ml）during the surgery, and the operation time was 45 -70 min （average 57.5 min）. 34 patients were followed up for 8 - 26 （ average 14.8） months and there was no death. The fracture healing time was 8 - 12 （ average 8.9）weeks. Evaluation of joint function was as following： 25 cases were excellent,6 cases were good,2 cases were suitable, 1 case was not up to the standard. The fineness rate was 91.2%. Conclusion This method which has the features of small surgical trauma, quick fracture healing and good recovery of joint function can determine the location and length of incision. This is an effective method to treat the senile stable intertroehanteric fracture.