外固定架结合中药内服治疗老年股骨粗隆下骨折

Treating femoral subtrochanteric fractures with unilateral external fixation apparatus and TCM

目的:探讨外固定支架结合中药内服治疗老年性股骨粗隆下骨折的临床疗效。方法:自2007年1月～2009年12月手术治疗老年股骨粗隆下骨折21例。所有患者均行外固定支架治疗,术后第1天开始加用中药口服,记录手术时间、出血量、骨折愈合时间、外固定架拆除时间,患者髋关节功能恢复情况(优良率),并发症发生率。结果:21例患者均获随访,随访时间10个月～24个月(平均18个月)。21例患者平均手术时间为(1.5±0.3)h,出血量(86±19)mL,平均骨折愈合时间l2周,平均外固定时间20周。术后l2个月随访时Harris评分(83.53±4.80)分,优10例,良5例,可5例,差1例,优良率为95.24%。并发症情况:针道感染2例,膝关节僵硬者1例,未出现外固定螺钉断裂病例。结论:外固定架结合中药内服是一种治疗老年性股骨粗隆下骨折的有效方法,创伤小,可加快骨折愈合速度,髋关节功能恢复满意。

Objective：To investigate the therapeutic effect on femoral subtrochanteric fractures for the treatment method of unilateral external fixation apparatus and traditional Chinese medicine.Methods： We retrospectively reviewed the clinical and radiological records of 21patients with unilateral external fixation apparatus and traditional Chinese medicine from January 2007 to December 2009, The opetation time,the quantity of bleeding,the fracture healing time, the incidence of complications, the functional evaluation of hip joint （the rate of excellent and good results） were compared and the curative effects were analyzed.Results： All the patients were followed up for 18 months in average （from 10 months to 24 months） . The average operation time was （ 1.5±0.3 ） h, the average quantity of bleeding was （86±19） mL,average fracture healing time was 12 weeks, average fixed time was 20 weeks. Harris score was （83.53±4.80） points, evaluation excellent for 10 cases, good for 5 cases, general for 5 cases, badly satisfaction for 1 cases（Harris standard）, and the excellent rate was 95.24%. The incidence of complications： pin infection in 2 cases, the knee joint stiffness in 1 case, no screw fracture cases.Conclusion： The unilateral external fixation apparatus and traditional Chinese medicine is a good choice for treating femoral ubtrochanteric fracture,because of the less injury, The faster fracture healing speed, and the better recovery of hip joint function.