滑动加压鹅颈钉治疗股骨粗隆间骨折

Treatment of Intertrochanteric Fracture with Dynamic Hip Screw

目的：用手术方法治疗老年人股骨粗隆间骨折，减少并发症及死亡率，尽早恢复病人生活能力。方法：用滑动加压鹅颈钉内固定治疗粗隆间完全骨折。结果：３５例病人用ＤＨＳ固定治疗，术后随访２月～５年，疗效满意。结论：作者认为ＤＨＳ是目前治疗粗隆间骨折较好的内固定物。但骨质严重疏松病人（Ｓｉｎｇｌｅ分类３级以下）不宜做此内固定。小粗隆为压力侧骨碎片，Ｅｖｅｎ分类Ⅲ度、Ⅳ度骨折的病例应固定小粗隆，恢复压力侧骨皮质连续性。

Objective:To treat senile intertrochanteric fractures with surgical intervention to decrease complication and mortality rate and let the patients recover early.Methods:35 patients with intertrochanteric fractures were treated surgically with dynamic hip screw (DHS).Results:The patients were followed up from two months to five years.Postoperative outcome was satisfactory.Conclusions:The authors consider that DHS is the optimal implant for treatment of intertrochanteric fracture at present.But it is inappropriate for patients with severe osteoporosis (below grade Ⅲ of Single classification).It is necessary for the cases with lesser trochanter fragment (grade Ⅲ and Ⅳ of Even classification) to fix the lesser trochanter in order to reconstruct integrity of the compressed cortex.