非手术治疗老年人股骨粗隆间骨折的疗效观察

Curative effect of non-surgical treating old people′s intertrochanteric fracture of femur

目的探讨老年人股骨粗隆间骨折的非手术疗法及疗效。方法对我科2006~2007年收治的116例60岁及以上的股骨粗隆间骨折患者进行骨科的三期辩证施治。根据分型及全身情况分别采取骨牵引或泡沫带牵引的非手术治疗方法。同时针对并存疾病积极内科对症支持治疗,预防或降低并发症及病死率。结果1例患者在住院期间突发心肌梗死死亡,6例患者因不同原因住院不足7d后,家属放弃治疗自动出院,其余109例按照国家中医管理局颁发的中医骨伤病症诊断疗效标准,治愈101例,好转5例,未愈3例。结论我院采用非手术治疗股骨粗隆间骨折病死率远较国外文献报道低,治愈率高。传统的牵引治疗股骨粗隆间骨折,具有创伤小,方式简单,费用低的优点,适用于不能耐受手术,粉碎性骨折及骨质严重疏松,内固定不稳,经济较为困难者。但对反粗隆间骨折伴有内后方大块粉碎骨折者,其闭合复位和维持骨位均十分困难,应尽可能选择股骨近端髓内钉（PFN）或动力髁（DCS）内固定提高股骨粗隆间骨折的整体治疗效果。

Objective To investigate treatment and curative effect of non-surgical treating old people＇s intertrochanter fracture of femur.Methods Treat 116 patients that are more than or equal to sixty years old from 2006 to 2007 according to orthopedic three-phase syndrome differentiation and treatment.We carry out separately skeletal traction or skin traction based on fractural classification and general situation.At the same time,we treat concurrent disease actively by symptomatic treatment to prevent or reduce complication and mortality rate.Results 1 patient died of acute miocardial infarction in hospital stay.6 patients,stay in hospital was less than 7 days.They gave up treatment and discharged from hospital.109 patients were evaluated through criterion of diagnosis and therapeutical effect in orthopedics and traumatology syndrom of TCM that awarded by administration of TCM： Cure 101 patients,Get better 5 patients,Be uncured 3 patients.Conclusion Report of mortality is lower than foreign literature＇s through our non-surgical treating old people′s intertrochanteric fracture of femur,cure rate is higher.Treating old people′s intertrochanteric fracture of femur through traditional traction have many advantages： small injury,simple means,low cost etc and is applicable to the patients that can not afford operation,have syntripsis,severe osteoporosis,unstable internal fixation and the poor.We still suggest treat anfi-intertrochanteric fracture of femur with inside syntripsis of rear through operation to improve general curative effect,for example： PFN or DCS.