老年人髋骨骨折临床分析

Clinical Analysis of Hip Fracture in the Elderly

目的:分析老年人髋骨骨折常规治疗基础上联合中医疗法的效果。方法:回顾性分析58例髋骨骨折患者的临床资料,股骨粗隆间骨折31例,其中股骨近端带琐髓内钉(PFN)治疗19例,动力髋螺钉(DHS)固定治疗12例。股骨颈骨折27例,闭合复位内固定治疗13例,切开复位内固定9例,人工关节置换术5例。术后给予其中医疗法(口服麝香接骨胶囊同时外敷活血接骨散)治疗。结果:股骨粗隆间骨折愈合29例(93.5%),PFN固定愈合18例(94.7%),DHS固定愈合11例(91.7%)。股骨颈骨折内固定愈合20例(90.9%),闭合复位内固定愈合12例(92.3%),切开复位内固定愈合8例(88.9%);粗隆间骨折髋关节功能优13例,良15例,差3例,优良率为90.3%;股骨颈骨折髋关节功能优10例,良14例,差3例,优良率为88.9%。粗隆间骨折患者1例术后表浅感染,1例内固定松动;股骨颈骨折闭合内固定治疗1例股骨颈缩短,切开复位内固定2例股骨头坏死。结论:无手术禁忌老年髋骨骨折患者应尽早接受手术治疗,并根据患者的个体情况选择内固定、外固定和关节置换术治疗;术后给予中医疗法可提高患者手术效果,促进骨愈合,减少术后并发症。

Objective： Analysis of elderly hip on the basis of conventional therapy combined with TCM therapy of fractures. Meth- ods：A retrospective analysis of the clinical data of 58 cases of hip fracture patients, 31 cases of femoral intertrochanteric fracture, proximal femoral intramedullary nail （PFN） and 19 cases were treated with dynamic hip screw （DHS） fixation in 12 cases. 27 cases of femoral neck fractures, closed reduction and internal fixation in 13 cases, open reduction and internal fixation 9 cases, 5 cases of artificial hip replacement. After giving the Chinese medicine therapy （oral shexiangjiegu capsule and external huoxuejiegu powder）. Results：Intertrochanteric femoral fracture healing in 29 cases （93.5 %）, PFN （94.7 %）, 18 cases of healing DHS fixed healing in 11 cases （91.7%）. Internal fixation of femoral neck fractures healed in 20 cases （90.9 %）, closed reduction and internal fixation healing in 12 cases （92.3 %）, open reduction and internal fixation, healing in 8 cases （88.9 %） ; intertrochanteric fractures of the hip joint function was excellent in 13 cases, good in 15 cases, poor in 3 cases, good rate of 90.3%; femoral neck fracture of hip joint function was excellent in 10 cases, good in 14 cases, poor in 3 cases, the excellent rate of 88.9 %. intertrochanteric fractures in pa- tients with 1 cases of postoperative superficial infection in 1 cases. Internal fixation loosening; femoral neck fracture fixation in the treatment of 1 cases of femoral neck shortening, open reduction and internal fixation of 2 cases of femoral head necrosis. Conclu- sion：No contraindication for elderly hip fracture patients should receive surgical treatment as soon as possible, and according to the individual situation of patients with internal fixation, external fixation and arthroplasty for treatment of osteoporosis; Postoperative treatment can improve the operation effect of patients.