亚洲型髋关节髓内钉治疗老年不稳定型股骨粗隆间骨折的效果分析

Analysis of effect of Asian IMHS in treating elderly patients with osteoporotic unstable femoral intertrochanteric fractures

目的探讨亚洲型髋关节髓内钉治疗老年不稳定型骨质疏松性股骨粗隆间骨折的临床效果，并总结相关经验。方法2010年6月～2012年10月首都医科大学附属北京复兴医院采用亚洲型髋关节髓内钉治疗65岁以上老年不稳定型股骨粗隆间患者45例，观察所有患者术前准备时间、手术时间、术中失血量、骨折愈合时间及髋关节功能Harris评分。结果随访6～18个月，平均12．6个月。术前准备时间1～7d，平均3．6d。手术时间为45～90min，平均67．1min。术中失血量为t00～250mL，平均151．7mL。骨折愈合时间为9～15周，平均11．8周。术后髋关节功能Harris评分优良率为92．7％。并发症方面，本组患者无髋内翻、股骨头切出、内固定断裂等并发症发生。结论亚洲型髋关节髓内钉是治疗老年不稳定型骨质疏松性股骨粗隆间骨折的有效手段，具有创伤小、操作简便、固定牢靠等优点．临床疗效满意。

Objective To evaluate the effect of Asian intramedullary hip screw in treating elderly patients with unstable femoral osteoporotic intertrochanteric fractures, meanwhile to sum up the relevant experience. Methods 45 elderly pa- tients ≥65 years old with unstable femoral intertrochanteric fractures were treated with Asian IMHS from June 2010 to October 2012 in Beijing Fuxing Hospital Affiliated to Capital Medical University. The preoperative preparation time, operation time, amount of blood loss, time of fracture union and Harris score of the hip function were evaluated. Re- suits All the patients were operated successfully, follow-up durations ranged from 6 to 18 months （mean 12.6 months）. Pre- operative preparation time： 1-7 days with an average of 3.6 days; operation time： 45-90 min with an average of 67.1 rain; amount of blood loss： 100-250 mL with an average of 151.7 mL; time of fracture union： 9-15 weeks with an average of 11.8 weeks. The Harris hip score functional criteria： excellent rate was 92.7%. No patients with coxa vara, femoral head cutting out, failure of internal fixation and other postoperative complications were found. Conclusion Asian IMHS is quite effective for treating elderly unstable femoral intertrochanteric fractures with easy performance, less blood loss and stable fixation. The clinical efficacy is satisfactory.