多排CT三维重建在股骨粗隆间骨折治疗中的临床应用

Clinical application of Multi-slice CT three-dimensional reconstruction in treatment of femoral intertrochanteric fracture

目的利用多排CT三维重建对股骨粗隆间骨折进行分型，根据分型指导临床治疗，观察手术疗效。方法自2008-01—2010—01对99例股骨粗隆间骨折根据多排CT分型标准进行分型，然后分别行动力髋螺钉（DHS）、股骨近端防旋髓内钉（PFNA）内固定及人工髋关节置换术治疗，评价手术疗效及分型方法对术式选择的指导意义。结果97例获得平均18（6-30）个月随访，术后1年髋关节功能Harris评分：优64例，良28例，可4例，差1例，优良率94．8％。结论根据多排CT三维重建对股骨粗隆间骨折进行分型，然后再依据骨折分型选择治疗方法，提高了手术疗效，减少了骨折并发症。

Objective To classify the femoral intertrochanteric fractures based on the multi-slice CT three-dimensional reconstruction and select treatment methods according to the classification to improve the surgical result. Methods A total of 99 femoral intertrochanteric fracture cases were treated with Multi-slice CT three-dimensional reconstruction between January 2008 and January 2010, which were classified by our hospital femoral intertrochanteric fractures standard. The overall situation of the patients were evaluated, and DHS, PFNA, hip replacement, or other approaches were performed for the patients. The surgical result and the classification for selection of treatment were evaluated. Results Ninty seven cases were followed up for 6 to 30 months after operation. According to the Harris score： excellent in 64 cases, good in 28 cases, fair in 4 cases and poor in 1 case, with excellent and good rate of 94.8%. Conclusion The new classification is more accurate by multi-slice CT three-dimensional reconstruction, which improves the surgical result, and reduces complications, based on fracture types, patient＇s age, physical condition and bone mass.