老年性股骨下端骨折内固定材料选择及疗效对比分析

Internal Fixation Materials Selection and Comparative Analysis of Its Curative Effect of Senile Femur Lower End Fracture

目的探讨老年性股骨下端骨折内固定材料的选择及临床疗效,为老年性股骨下端骨折的临床治疗方案选择提供依据.方法 132例老年性股骨下端骨折患者均采用内固定的手术方式进行治疗.其中,32例应用动力髁螺钉(DCS),60例应用逆行交锁髓内钉,40例应用股骨髁支持钢板.随访6～18个月,按照疗效标准采用回顾性分析方法进行疗效分级统计,并对3种不同固定材料患者愈合的优良率进行统计学分析,分析选取的3种不同固定材料的临床治疗效果.结果使用内固定材料治疗老年性股骨下端骨折均见好转,使用逆行交锁髓内钉的优良率是100%,使用动力髁螺钉的优良率是96.2%,使用股骨髁支持钢板的优良率是90.0%.t检验分析,3组间差异有统计学意义(P<0.05).使用逆行交锁髓内钉的患者愈合的优良率较高,好于动力髁螺钉和股骨髁支持钢板.结论 3种内固定方法治疗老年性股骨下端骨折均取得良好效果,使用逆行交锁髓内钉的优良率较高.

Objective To discuss the selection of internal fixation materials and the comparison of its clinical curative effect to provide an evidence for establishing the clinical treatment scheme of senile femur lower end fracture. Method 132 Cases were treated by using internal fixation operation. 32 cases of them were treated with dynamic condyle screw （DCS） ,60 cases with retrograde interlocking intramedullary nail and 40 cases with femoral condyle support steel plate. They were followed up for 6 - 18 months. The curative effect classification statistics were carried out by using retrospective analysis method according to the standard of curative effect to analyze the excellent healing rate of the three different fixation materials statistically, namely, to observe whether there would be some significant differences among the three different fixation materials selected in clinical therapeutic effect. Results The senile femur lower end fracture treated with internal fixation were improved. The excellent rate of cases treated with retrograde interlocking intramedullary nail was 100%, that with dynamic condylar screw was 96.2%, and that with femoral condyle support steel plate was 90.0%. The t test analysis showed P 〈 0.05 among three groups,indicating that the difference among them was statistically significant. The screw and the femoral condyle support steel plate. Conclusion The application of three kinds of internal fixation methods for the treatment of senile femur lower end fracture could achieve a good effect and the excellent rate with the retrograde intramedullary nail should be highest, suggesting that the internal fixation method is supposed to be used widely in clinic.