股骨转子部骨折的手术治疗

Surgical treatment of peritrochanteric femoral fractures

目的通过对不同类型的股骨转子部骨折的手术方法和结果进行回顾和分析,为临床工作提供依据。方法从2000～2003年对78例不同类型的股骨转子部骨折(股骨颈基底骨折12例,股骨转子骨折36例,转子下骨折16例,反转子间骨折10例,单纯大转子骨折4例)采用不同内固定进行手术治疗,平均随访22.5个月(8～32个月),采用Sanders法对术后效果进行评定。结果优(55～60分):28例(占35.9%),良(45～54分)38例(占48.7%),差(35～44分)11例(占14.1%),失败(<35分)1例(占1.3%)。总优良率为84.6%。结论对股骨转子部不同类型的骨折,明确诊断,正确使用内固定及其操作方法,术后积极功能锻炼是治疗成功的关键。

Objective To review and analyze the operative methods and postoperative results of treatment of various types of peritrochanteric femoral fractures so as to provide reference data for clinical work. Methods 78 cases of various types of peritrochanteric femoral fractures were treated with operation using various internal fixators from 2000 to 2003. The average follow up time was 22.5 months (8 to 32 months). The postoperative results were evaluated according to Sanders Score System. Results Of the 78 cases, 28 were excellent (35.9%), 38 good (48.7%),11 fair (14.1%) and 1 failure(1.3%). The excellent and good rate was 84.6%. Conclusion Accurate diagnosis, reasonable application of internal fixators and early active functional rehabilitation are the keys to obtain a good clinical result.