不同手术方法治疗老年股骨转子间骨折疗效分析

Curative effect of different surgeries on femoral intertrochanteric fracture in elderly patients

[目的]探讨动力髋螺钉、股骨近端髓内钉、人工股骨头置换术及外固定架治疗老年股骨转子间骨折的临床疗效。[方法]对本院2005年1月～2010年1月以不同手术方法治疗的老年股骨转子间骨折资料完整患者196例进行回顾性研究,其中应用动力髋螺钉治疗68例,股骨近端髓内钉治疗57例,人工股骨头置换术治疗47例,外固定架治疗24例。[结果]所有患者均获得随访,时间12～24个月,平均19个月。四组疗效满意,优良率比较差异无显著性意义(P>0.05),优良率分别为:动力髋螺钉88.2%,股骨近端髓内钉94.7%,人工股骨头置换术91.4%,外固定架87.5%。[结论]4种手术方法均可以有效地治疗老年股骨转子间骨折,但应根据患者年龄、身体状况、骨质疏松情况、骨折类型等情况进行综合评估,从而选择最合理手术方式,取得最好的效果。

[ Objective] To analyze the efficacy of dynamic hip screw（ DHS）, proximal femoral mail（ PFN ）, artificial femo- ral head replacement and external fixation to remedy the femoral intertrochanteric fracture in elderly patients. [ Method] A retro- spective study of 196 patients with femoral intertrochanteric fractures treated in our hospetal from January 2005 to January 2010 was made. They were treated with DIIS （68 cases） , PFN （57 cases） , artificial femoral head replacement（47 cases） and exter- nal fixation （24 cases）. [ Result] All cases had been followed up for 12 -24 months, （average 19 months）. All patients received a satisfactory effect and there were no differences in the acceptable rate of 88.2% to DHS,94.7% to PFN,91.4% to artificial femoral head replacement and 87.5% to external fixation.[ Conclusion[ Four kinds of treatment are effective for the elderly pa- tients with femoral intertrochanteric fracture. We should take the patients age, body circumstance,osteoporosis, fracture type into account and choose a reasonable operation method to achieve a satisfactory clinical effect.