老年股骨粗隆间骨折不同内固定疗效分析

Treatment of Different Internal Fixation to Elderly Femoral Intertrochanteric Fracture

目的:探讨老年股骨粗隆间骨折的治疗方法及内固定治疗粗隆间骨折的适应证。方法:应用动力髋螺钉(DHS)、动力髁钢板(DCS)、Gamma髓内钉、股骨近端重建带锁髓内钉及防旋股骨近端髓内钉(PF-NA)治疗老年人股骨粗隆下骨折共65例,其中DHS组18例、DCS组8例、Gamma钉组23例、重建钉组14例、PFNA组2例。结果:65例均获随访,随访时间8～18个月。平均12个月骨折愈合时间4～12个月。平均8个月。其中3例术后因其它疾病死亡,其余根据Harris髋关节评分优48例,良7例,可4例,差3例。结论:Gamma钉、重建钉及PFNA它们更符合生物力学的特点为首选的内固定器械。

Objective：To study the effects of internal fixation in treating the intertrochanteric fractures in the elderly and discuss the operating indication ot internal fixation.Methods：Sixty-five cases of the intertrochanteric fractures in the elderly were treated by the dynamic hip screw（DHS）,dynamic condylar screw（DeS）,Gamma nail,reconstruction interlocking nail and proximal femoral nail anti-rotation（PFNA 1all the cases were hllowed up of all,18 cases were treated with DHS,8 with DCS,23 with Gamma nail,14 with reconstruction interlocking nail and 2 with PFNA.Results：The average duration of follow up was 12 months（range,8 to 18 months）.The average duration of the healing time was 8 months（range,4 to 12 months）.of which 3 patients died due to other diseases.The functional evaluati on was done with Harris hip rating scale,of the 62 cases,48 were excellent,7 good,4 fair and 3 poor.Conclusion：Gamma nail,reconstruction interlocking nail and PFNA are preferred internal fixation.They are more in line with the characteristics of biomechanics method for the treatment of aged subtrochanteric fractures.