内固定治疗老年股骨粗隆间骨折回顾性分析

Retrospective analysis of internal fixation in the treatment of intertrochanteric fractures in the elder

目的回顾性分析内固定治疗老年股骨粗隆间骨折的临床疗效。方法根据骨折Evans分型,分别采用空心钉、LPFP、DHS及PFNA内固定治疗,配合补血壮骨中药口服,根据髋关节功能评分(Harris评分)评价疗效。结果随访63例患者手术切口一期愈合,畸形愈合2例、肢体短缩1例、髋内翻和继发骨折0例、内固定物断裂松动3例。髋关节功能评定根据Harris评分,优(≥90分)29例,良(80~89分)28例,差6例,髋关节功能恢复优良率为90.5%。结论空心钉、LPFP、DHS及PFNA均是治疗老年股骨粗隆间骨折的有效方法,临床医生应严格按照骨折分型选择不同的内固定方法,以增强骨折内固定的稳定性,提高股骨粗隆间骨折的手术疗效。

Objective Retrospective analysis of the clinical effect of internal fixation in the treatment of intertrochanteric fractures in the elder. Methods According to Evans classification of fracture, all cases of femoral intertrochanteric fractures treated by hollow compression screw, locking proximal femur plates （LPFP）, dynamic hip screw （DHS）, and proximal femoral nail anti-rotation （PFNA）. At the same time, oral Chinese medicine in post- operation. And apply Harris score to compared the curative effects of the four methods. Results 63 patients were followed up for the first time, malunion was found in 2 cases, 1 cases of limb shortening, hip varus 0 case, secondary fracture 0 case, internal fixation loosening 3 cases. According to Harris score, excellent is 29 cases, good is 28 cases, poor is 6 cases. The percentage of good hip function after operation was 90.5%. Conclusion Cannulated screws, LPFP, DHS and PFNA are effective methods for the treatment of intertrochanteric fractures in the elderly. According to different types, doctors choose internal fixations to enhance the stability of internal fixations and improve the surgical curative effect.