高龄患者股骨粗隆间骨折内固定术式的选择分析

Analysis of the Choice for Intertrochanteric Fracture Fixation in Elderly Patients

目的观察股骨粗隆间骨折不同内固定方法的治疗疗效。方法选取2011年1月至2015年3月在我科住院的大于60岁共72例股骨粗隆间骨折患者,分别采用空心钉、动力髋螺钉（DHS）、防旋股骨近端髓内钉（PFNA）等方法内固定,进行术中术后随访,对比三组骨折分型、手术时间、术中出血量、骨折愈合时间、Harris评分及术后并发症等指标。结果本组术后随访6~50个月。三组比较,手术时间、术中出血量、骨折愈合时间、Harris评分差异均有统计学意义（P〈0.01）。有8例内固定失效,占总患者数11.11%,其中空心钉3例,DHS 3例,PFNA 2例。结论对于合并多种基础病的老年股骨粗隆间骨折患者的治疗,在C臂下闭合牵引复位PFNA内固定术具有明显的优势。

Objective To observe the treatment efficacy of different intertrochanteric fracture fixation methods. Methods January 2011 to March 2015 in our hospital,more than 60 years,a total of 72 cases of intertrochanteric fractures fixed within the hollow screw,DHS,PFNA and other methods,were carried out intraoperative and postoperative follow-up,compared to three Group of fracture type,operation time,blood loss,fracture healing time,Harris score and postoperative complications. Results This group were followed up for 6 to 50 months. Three groups of operative time,blood loss,fracture healing time,Harris score differences had a statistically significant（ P〈0. 01）. There were eight cases of internal fixation failure（ 11. 11% of the total number of patients）,including hollow nails,three cases of DHS,two cases of PFNA. Conclusion For elderly patients with multiple underlying diseases of fracture treatment with intertrochanteric,the C-arm closed traction reduction PFNA of internal fixation has obvious advantages.