闭合复位AO/ASIF L-135°角钢板内固定治疗老年股骨转子间骨折

Closed reduction and AO/ASIF L-135° steel panel internal fixation treat old people remoral intertrochauteric fracture

目的：评价应用ＡＯ／ＡＳＩＦ Ｌ－１３５°角钢板内固定治疗老年人股骨转子间骨折临床效果．方法：从１９９３年１０月至１９９９年１１月采用闭合复位有限切开ＡＯ／ＡＳＩＦＬ－１３５°角钢板内固定，治疗老年人股骨转子间骨折２１例．平均年龄７７岁．手术在骨牵引床上，“Ｃ”型壁Ｘ光机透视下进行，闭合复位满意后，有限手术切开，依定位克氏针为导向打入用板．大小转子骨折用拉力螺钉固定。不稳定骨折加用一枚空心螺钉固定。结果：本组病人全部获得随访，最长６年，最短１１个月，骨折愈合恢复伤前生活，颈干角１３５°～１１０°１８例，占８６％。颈干角≤１１０°３例，占１４％．结论：应用ＡＯ／ＡＳＩＦ Ｌ－１３５°钢板固定治疗老年人股骨转子间骨折，固定可靠，手术创伤小，操作简单，价格低廉。强调术后不负重关节活动和体能锻炼，骨折来愈合前不能完全负重活动，防止颈干角丢失．

Objective: To appraise the effect of intermal fixatioh with AO/ASIF L-135° Steel panel used in treat- ment of old people femoral intertrochanteric fracture. Methods:21 cases,average age 77 years old.The operation was carried on bone traction bed by finite saft tissue open after good closed reduction under X-ray. The fixation steel plate was installed according to the direction of the guided needle. Either greater trochanter fracture or lesser trochanter fracture was fixed all by pull screws. The unstable fracture was fixed by a another bollow screw. Results: The all patients have been followed for 11 months to 6 years postoperatively. The fracture was union and the neck stem angle was, 135°- 110° l8 case ≤110° 3 case. Conclusion:The fixation with AO/ASIF L-135° steel plate is reli- able,the operation is minitrauma and with low price. It is emphasized to exercise without weight-lood before the fracture union,in order to prevent neck stem angle drop.