解剖型锁定接骨板治疗老年股骨粗隆间骨折的疗效分析

Clinical Analysis of the Treatment of Senile Femoral Intertrochanteric Fracture with Anatomical Locking Bone Plate

目的：探讨股骨近端解剖型锁定接骨板治疗老年股骨粗隆间骨折的临床疗效.方法：回顾性分析我科近2年间手术治疗老年粗隆间骨折57例的临床资料,其中应用解剖型锁定接骨板32例（A组）,应用非锁定接骨板25例（B组）,对比其临床效果.结果：57例患者术后随访6～18个月,平均10.7月.A组32例骨折全部愈合,平均愈合时间为5.5个月;无一例内固定松动现象,2例出现轻度髋内翻.B组25例中,21例骨折愈合;4例术后出现内固定松动,其中3例骨折延迟愈合,1例骨不愈合,均继发不同程度的髋内翻畸形.采用Kuderna评分评估髋关节功能,A组优25例,良5例,可2例,优良率93.75%;B组优13例,良5例,可4例,差3例,优良率72%.两组差别具有统计学意义（P＜0.01）.结论：解剖型锁定接骨板治疗老年股骨粗隆间骨折符合生物力学的要求,操作简便,创伤少,固定坚强,髋内翻等并发症少,骨折愈合率高,是治疗粗隆间骨折的理想方法.

Objective：To evaluate the clinical effects of anatomical locking bone plate in the treatment of senile femoral intertrochanteric fracture. Methods：The clinical data from 57 cases with senile femoral intertrochanteric fracture who were treated in our hospital during the last two years were analyzed retrospectively. Among them, 25 cases received operations with unlocking bone plate, and 32 with anatomical locking bone plate. Results：57 patients had been followed up for 6 - 18 months, an average of 10.7 months. 32 fractures in group of anatomical locking bone plate healed after an average of 5.5 months, no implantation loosing was observed hut 2 cases with coxa vara. In group of unlocking bone plate ,21 fractures healed ,4 cases with implantation loosing and coxa vara were observed, 3 fractures were delayed - union and 1 disunion. According to Kuderna criterion, in anatomical locking bone plate treatment group, the function of thigh joint was excellent in 25 cases, good in 5 and fair in 2, the fineness ratio was 93.75% and 72% in unlocking bone plate group with 13 excellent, 5 good, 4 fair and 3 bad, there was statistically difference （ P 〈 0.01 ）. Conclusions ： In fixation of senile femoral intertrochanteric fracture, anatomical locking bone plate compared is an ideal method, adapting to the demands of biomechanics with simple operation, little invasive injury, stable fixation and few complications and satisfactory bone union rate.