股骨近端解剖型锁定钢板治疗股骨粗隆间骨折42例

To investigate the anatomical proximal femoral locking plate for treatment of femoral intertrochanteric fractures in 42 cases

目的 探讨股骨近端解剖型锁定钢板治疗股骨粗隆间骨折的临床疗效.方法 回顾性分析2008年1月～2013年6月收治且获随访的42例股骨粗隆间骨折患者,男18例,女24例;年龄47～86岁,平均66.5岁.致伤原因：骑车摔伤12例,不慎跌伤9例,高处坠落伤7例,车祸交通伤14例.按国际内固定研究学会（AO/OTA）分型：A1型12例,A2型19例,A3型11例.受伤至手术时间为2～12天,平均5.8天.所有患者均采用股骨近端解剖型锁定钢板治疗.结果 42例患者术后均获6～18个月随访,平均12.2个月.本组患者骨折愈合时间为3～13个月,平均5.6个月.所有患者均一期愈合,无一例发生切口延迟愈合或感染.末次随访时根据髋关节Harris评分标准评定疗效：优20例,良18例,可4例,差0例,优良率为90.5％ （38/42）.术后1例发生下肢深静脉血栓形成,1例老年患者发生褥疮,并发症发生率为4.76％ （2/42）.本组无死亡病例,无螺钉松动、断钉、髋内翻及肢体短缩等并发症发生.结论 股骨近端解剖型锁定钢板治疗股骨粗隆间骨折具有手术操作简便、固定可靠、并发症少及能早期功能锻炼等优点,是一种理想的治疗方法.

Objective To investigate the anatomic locking plate for treatment of femoral intertrochanteric fractures. Methods A retrospe-ctive analysis was performed for 42 patients with intertrochanteric fractures who had been followed up from January 2008 to June 2013,18 males and 24 females; aged from 47 to 87 years, mean 66.5 years. The causes of injury： 12 cases of rider falls, 9 cases of accidental falls, 7 cases of injury falls, 14 cases of traffic accident injuries. AO fracture classification： A1 12 cases, A2 type 19 cases, A3 11 cases. Injury tosurgery time was 2 to 12d, an average of 5.8 d. All patients were treated with anatomic locking plate fixation. Results 42 patients were tbllo-wed up for an average of 12.2 months （6 to 18 months） after operation. The fracture healing time of this group was 3 to 13 months, with an average 5.6 months. All patients were healed, no incision delayed healing or infection. At last follow-up, the efficacy was evalu-ated based on the standard of Harris hip score., excellent in 20 cases, good in 18 cases, acceptable in 4 cases, no bad case, the excellent and good rate was 90.5% （38/42）. One case was in deep vein thrombosis after operation, One case of elderly patients with bedsores, acomplication rate was 4.76% （2/42）. There were no deaths, no loose screws, no broken nails, no limb shortening varus and other complications. Conclusion With the advantages ofsimple operation, reliable and secure fixation, less morbidity and ability of early exercise, etc, anatomic locking plate treatment of intertrochanteric fractures of the surgical procedure fewer complications is an ideal treatment method.