老年人骨质疏松性髋部骨折100例治疗探讨

Treatment of osteoporotic hip fracture in the elder

目的探讨老年人骨质疏松性髋部骨折的临床诊治方法及疗效。方法对70～96岁的骨质疏松性髋部骨折100例实施不同的方法治疗的(其中股骨粗隆间骨折29例中,DHS内固定20例,保守治疗8例,人工股骨头置换1例;股骨颈骨折71例中,人工股骨头置换33例,全髋置换38例)的同时,配合抗骨质疏松药物治疗。结果 100例均获得随访。随访时间6～28个月,平均14.2个月。术后股骨头缺血坏死4例;内固定物松动滑脱5例,断裂2例;人工股骨头下沉致疼痛5例;84例恢复行走功能。结论老年骨质疏松性髋部骨折需要采取积极的以手术为主的综合治疗。

Objective To explore the treatment method and effect of osteoporotic hip fracture in the elder. Methods One hundred patients over 70 years old （ age ranging from 70 -96） with osteoporotic hip fracture were treated by surgery （92 patients） or no-operation 8 patients. There were 39 males in the series. Their mean age was 74. 4 years. And there were 61 female, their mean age was 71.3 years. Out of 29 patients with femoral intertrochan- teric fracture, 20 patients were treated by DHS internal fixation. Eight patients were treated by non-operative meth- ods. One patient by replacement of artificial femoral head. Among 71 patients with femoral neck fracture, 33 patients were treated by replacement of artificial femoral head, and 38 patients by total hip arthroplasty. All patients were treated with antiosteopomtic drugs. Results All patients were followed up for an average 14. 2 months （ranged from 6 months to 28 months）. After treatment, femoral head ischemia and necrosis were found in 4 patients. The internal fixation loosening or slipping in 5 patients. The break of internal fixation in 2 patients. Pain caused by artificial femo- ral head sinking in 5 patients. Eighty-four patients achieved satisfactory results. Conclusion The treatment of osteo- porotic hip fracture in the elderly can achieve satisfactory results if the comprehensive therapies are given on the basis of surgery.