摘要
目的分析股骨粗隆间骨折内固定手术治疗方法和影响因素,以提高股骨粗隆间骨折内固定手术疗效。方法 2000年以来收治196例股骨粗隆间骨折,行内固定治疗并获随访者72例,时间平均为11个月。60例患者采用动力髋螺钉,4例患者用Gamm a钉,3例股骨近端髓内钉,其他内固定5例。通过对住院期间和门诊随访的临床资料观察,回顾性分析股骨粗隆间骨折不同内固定手术治疗方法和影响手术疗效的因素。结果 72例术前准备后行手术治疗。术后死亡1例,其他71例患者随访5到18个月（平均时间是术后11个月）。70例股骨粗隆间骨折愈合,平均愈合时间3-6个月。髋关节功能良好62例,占87%。9例患者术后有并发症：2例伤口愈合不良为早期并发症,髋内翻2例,缩短1例,感染1例,断钉1例,退钉1例,不愈合1例。结论股骨粗隆间骨折应合理选择内固定方式。影响手术疗效的主要因素是：骨折端的几何形态、骨骼质量,内固定物的选择,小粗隆的复位及保持股骨内后侧骨皮质的完整性,手术创伤对老年患者的影响。
Objective To analyzed the internal fixation of intertrochanteric fractures treatment methods and influential factors,in order to improve the internal surgery.Methods Since 2000 year,196 cases with intertrochanteric fractures were treated in our department.72 cases received internal fixation therapy,and were followed up for an average of 11 months.60 of them were treated with dynamic hip screws,4 with Gamma nails and 3 with proximal femoral nails,and 5 cases with other internal fixation.Among them,there were 40 male and 32 female patients.The average age of the patients was 68 years old.65% of them suffered complicated medical disease.Through the observation of the hospital and follow-up clinical data retrospectively analysized intertrochanteric fracture fixation surgery in different ways and factors that affect the surgery.Results After peri-operative preparations,72 patients were successfully operated.1 patient died after operation,and the other 71 patients were followed up for 5 to 18 months（mean time was 11 months after operation）.The femoral intertrochanteric fractures of 70 cases were healed between 3 to 6 months after operations.62 cases of hip joint function was good,accounting for 87%.9（13.0%） cases had complications after operation.2 cases of wound healing disturbances of early.hip varus in 2 cases,shortening in 1 cases,infections in 1 case,1 case of broken nails,nail withdrawal in 1 case.1 case of nonunion.Conclusion Intertrochanteric femoral fracture should be reasonably selected fixation.Proper method should be determined on the basis of physical conditions and fracture types of the different patients.The main factors influencing surgical effect are： the bone fracture types and quality,the choice of internal fixation plant,the lesser trochanter be reset and the posteromedial bone cortex of femur be kept up integrity,and the influence of surgical trauma in elderly patients.
出处
《安徽医学》
2010年第6期604-607,共4页
Anhui Medical Journal
关键词
股骨粗隆间骨折
内固定手术
分析
Intertrochanteric fractures
Internal fixation therapy
Analysis
