老年人股骨粗隆间骨折的治疗

Treatment of intertrochanteric fractures in elderly

目的:探讨老年人股骨粗隆间骨折常用的两种治疗方法的临床疗效。方法:收集本院自2009年1月～2011年1月股骨粗隆间骨折72例,根据患者自愿的原则,随机分为骨牵引组和手术组,每组各36例,分别采用骨牵引和动力髋螺钉(DHS)手术结合早期加强功能锻炼的治疗方法,对临床疗效进行观察分析。结果:所有病例均顺利出院,无1例患者死亡。随访3个月～1年,骨牵引组36例:优13例,良12例,中7例,差8例,优良率为69.44%;手术组36例:优21例,良10例,中4例,差1例,优良率为86.11%,经Ridit分析,P<0.05,比较差异具有统计学意义。结论:DHS合并术后早期功能训练是治疗老年股骨粗隆间骨折较为理想的方法,在排除手术禁忌症的情况下应用具有安全稳定、并发症少、恢复快等优点。

Objective： To investigate the clinical efficacy of two treatment for intertrochanteric fractures in elderly. Methods.. A total of 72 patients with intertrochanteric fractures were randomly divided into skeletal traction group and surgery group according to the principle of voluntary by half. Patients in skeletal traction group were treated with skeletal traction and surgery group with dynamic hip screw surgery （DHS） combined with early functional exercise method. Results： All patients were discharged, and no one patient died. Follow-up for 3 months to 6 years showed that 13 cases were excellent, 12 cases were good 7 cases were medium and 8 cases were poor in the skeletal traction group while 21 cases were excellent, 10 cases were good, 4 cases were medium and 1 cases were poor in the surgery group. The good rate in the surgery group was 88.89%, significantly higher than 69.44% of skeletal traction group（P〈0.05）. Conclusions： DHS combined early postoperative functional training is an ideal method to treat elderly patients with intertrochanteric fractures. It is safe, stable, of fewer complications and faster recovery.