InterTan髓内钉治疗老年股骨转子间骨折的疗效

Effect of the elderly femoral intertrochanteric fractures treated with InterTan intramedullary nail

目的探讨InterTan髓内钉治疗老年股骨转子间骨折的疗效。方法采用InterTan髓内钉治疗86例老年股骨转子间骨折患者。记录骨折愈合情况及并发症发生情况,采用Baumgaertner改良标准评价骨折复位质量,采用髋关节功能Harris评分评价疗效。结果患者均获得随访,时间6~12(9.2±1.9)个月。术后无切口感染、下肢深静脉血栓形成等并发症发生,1例发生拉力螺钉切出。术后X线片显示骨折对位对线良好,内固定位置满意。除1例拉力螺钉切出导致骨折畸形愈合外,其余85例骨折均愈合良好。85例骨痂形成时间4~8(4.7±1.2)周,骨折愈合时间3~6(4.1±0.9)个月。末次随访时,采用Baumgaertner改良标准评价骨折复位质量:良好77例,可8例,差1例;采用髋关节功能Harris评分评价疗效:优28例,良51例,可6例,差1例,优良率为91.9%。结论InterTan髓内钉治疗老年股骨转子间骨折固定牢固,并发症少,有利于髋关节功能的恢复。

Objective To investigate the efficacy of InterTan intramedullary nail in the treatment of elderly femoral intertrochanteric fracture.Methods InterTan intramedullary nail was used to treat 86 patients with femoral intertrochanteric fractures.Fracture healing condition and complications were recorded.Baumgaertner modified criteria were used to evaluate the quality of fracture reduction,and the efficacy was evaluated with Harris score of hip function.Results All patients were followed up for 6~12(9.2±1.9)months.Postoperative complications such as incision infection and deep venous thrombosis of lower extremity were not observed.Lag screw extraction occurred in 1 case.Postoperative radiographs showed good alignment and satisfactory internal fixation.Except for 1 case of fracture malunion caused by lag screw removal,the other 85 cases of fractures healed well,who had obtained callus formation within 4~8(4.7±1.2)weeks and fracture healing within 3~6(4.1±0.9)months.At the last follow-up,the quality of fracture reduction was evaluated by Baumgaertner modified criteria:77 cases were good,8 fair,and 1 poor.The Harris score of hip joint function was used to evaluate the curative effect:excellent in 28 cases,good in 51,fair in 6,poor in 1,the excellent good rate was 91.9%.Conclusions InterTan intramedullary nail in the treatment of elderly femoral intertrochanteric fracture is firmly fixed with fewer complications,which is beneficial to the recovery of hip joint function.