鹅头钉与外固定支架治疗老年人股骨粗隆间骨折疗效分析

The effective analysis of the old patient with femoral inter-trochanter fracture use goose head nail and external fixation

目的 探讨鹅头钉系列与单侧外固定支架在治疗老年人股骨粗隆间骨折中 ,术前、术中及术后的情况及其对功能的影响。方法 随机抽取 1997年～ 2 0 0 0年 ,在我院接受手术治疗的 45例 6 4～ 93岁老年性股骨粗隆间骨折患者 ,将其分成鹅头钉系列内固定术组 (30例 ,A组 ) ,与单侧外固定支架组 (15例 ,B组 ) ,将患者年龄、入院至手术时间、住院时间、合并症、输血量、并发症、功能情况进行评估 ,随访时间 1～ 3年 ,平均 12个月。结果 两组在年龄、手术时间、住院时间、合并症、功能优良率方面差异无显著性 (P >0 .0 5 ) ;而在输血量、并发症方面差异有显著性。结论 在老年性股骨粗隆间骨折患者中 ,闭合复位 ,鹅头钉系列内固定术 ,固定牢固 ,创伤相对较大 ,严重并发症多 ,风险较大 ;而单侧外固定支架 ,创伤小 ,手术时间短 ,严重并发症少 ,风险小 ,但由于老年人骨质疏松 ,螺钉易松动 ,钉眼易感染。

Objective Forty five old patients from 64 93 years old, with femoral inter trochanter fracture treated by goose head nail system and lateral external fixation from 1997 2000. Methods All the patients were divided into two groups randomly. Group A (30 cases) were treated by goose head nail system; Group B (15 cases) were treated by lateral fixation, Their age, time of admission, time of operation, complications and function resteration were evaluated, These patients 1 3 years(mean 1 year) were followed up. Results It is shown that there were significant diffe rence in two groups of transfusing level and complications ( P <0.05), but no significant difference in two groups of age, time in operation, time of staying at hospital, the coexisting diseases, function restoration ( P >0.05). Conclusion We consider that (1) It can be close reducted and good stability by goose head system in the old patients with inter trochanter fracture, but bigger wound, high complications and risks. (2) The advantages are less wound, shorter operating time and low complications use external fixation. The disadvabtages are poor stability and higher infective rate.