老年股骨粗隆间骨折不同手术方式的临床应用评价

Operation Treatment Status of Intertrochanteric Femoral Fracture in Elderly Patients

本文针对当前日益高发的老年股骨粗隆间骨折,介绍其流行病学、致病因素和发病机制以及当前的治疗方法,着重阐述其手术治疗的学术地位,详细比较了DHS/DCS、Gamma钉/PFN以及PFNA等外科主流的内固定手术疗法,强调对有手术适应证的患者尽早做内固定以使骨折断端稳定、患者疼痛缓解,有利于患者尽早恢复日常活动和减少并发症的发生率。其中,尤其主张根据患者一般状况(骨折类型、骨质、年龄等)以及对生活和预后的要求等进行综合评估后,再选定一种合理的手术方案,应当争取在伤后2d^3d安排外科手术。

The view of this paper shows an currently increasingly high incidence of the intertrochanteric fracture of femur in the elderly, introduces its epidemiology, pathogenic factors and pathogenesis, and the current treatment methods, focuses on the surgical treatment of academic status, detailed internal fixation therapy and comparing with nail of Dynamic Hip Screw （DHS）/Dynamic Condylar Screw （DCS）, Gamma/Proximal Femoral Nails （PFN） and Proximal Femoral Nail Anti-rotation （PFNA）, etc. Surgical mainstream emphasis on operation indications of the patients as early as possible in order to make the stability of the fracture fixation, relieve of pain and help the patients early resumption of daily activities and reduce the incidence of complications. Among them, we especially advocate according to fracture type, individual patient specific bone status and age of patients, such as the general situation, as well as to the life and the prognosis of the requirement, to make a comprehensive assessment, and then select a reasonable surgical plan. Also the patients should try to arrange the surgical operation within 2d-3d after injury.