老年股骨转子间骨折治疗体会

Treatment Experience of Intertrochanteric Fractures in Elderly Patients

目的观察采用动力髋螺钉内固定和人工股骨头置换治疗股骨转子间骨折的疗效。方法采用动力髋螺钉内固定治疗股骨转子间骨折43例,人工股骨头置换13例,根据Harris评分标准对患者进行功能评定。结果本组56例患者,手术均顺利,切口均一级愈合。术后随访6～24个月,平均随访16个月,骨折全部愈合。DHS内固定组优24例,良15例,可4例,差0例,优良率为90.7%。人工股骨头置换组优9例,良3例,可1例,差0例,优良率为92.3%。结论动力髋螺钉和人工股骨头均是治疗老年股骨转子间骨折的理想方法,但要根据病情个体化治疗。

Objective To investigate the effect of dyramic hip screw （DHS） internal fixation and artificial femoral head replacement for the treatment of intertrochanteric fractures. Methods 43 patients with intertrochanteric fractures were treated with DHS internal fixation, 13 patients with intertrochanteric fractures were treated with femoral head replacement, according to Harris scoring criteria to carry out functional assessment in the patients. Results 56 patients＇ operations were successful, all the wound were healed. The patients were followed up for 6 to 24 months with an average follow-up of 16 months, all the fractures were healed. In DHS internal fixation group there were excellent in 24 cases, good in 15 cases, fair in 4 cases and poor in 0 case, the excellent and good rate was 90.7%. In artificial femoral head replacement group there were excellent in 9 cases, good in 3 cases, fair in 1 case and poor 0 case, the excellent and good rate was 92.3%. Conclusion Both DHS internal fixation and artificial femoral head replacement for the treatment of intertrochanteric fractures in the elderly patients are the ideal methods, but the treatment shall be individualized according to the disease.