摘要
目的 ：探讨股骨近端锁定钢板（PFP）治疗股骨转子间骨折的疗效与失败病例的分析。方法 ：2013年1月至2014年3月,采用施乐辉股骨近端锁定钢板治疗骨质疏松性EvansⅠ、Ⅱ型股骨转子间骨折32例,其中男17例,女15例;年龄70~86岁,平均77.3岁;采用Harris髋关节功能评分标准评价其疗效结果。结果：所观察32例患者的手术时间为（60.5±15.7）min,术中失血量（128.8±73.6）ml,患者围手术期输血量为（224.0±72.7）ml,住院时间14~20 d,平均17.2 d。出院后32例获随访,随访时间6~18个月,平均14.1个月。32例骨折全部愈合,愈合时间为3~6个月,平均3.1个月。1例出现内固定松动及退钉,4例出现尿路感染,1例术后6个月死于心血管疾病,2例术后1年死于脑卒中,未出现切口深部感染、内固定周围骨折、下肢深静脉血栓、内固定断裂、骨折不愈合、严重髋内外翻等。Harris功能评分平均为89.74±6.84;结果优10例,良16例,中4例,差2例。结论：股骨近端锁定钢板可予骨质疏松性股骨骨折的近端提供较稳定的固定把持,是治疗股骨转子间骨折的一种选择,可稳定骨折断端,保证骨折愈合。
Objectives：To investigate the effects of proximal femoral locking plate（PFP） in treating osteoporotic intertrochanteric fractures and to analyze the failure cases. Methods：Totally 32 patients with osteoporotic intertrochanteric fractures of EvansⅠandⅡwere treated with improved locking PFP,including 17 males and 15 females with an average age of 77.3 years old ranging from 70 to 86 years old. After operation,according to Harris hip scores,the hip function and therapeutic effects were evaluated. Results：The observed 32 patients＇ operative time was（60.5±15.7） min,intraoperative blood loss was（128.8±73.6） ml;perioperative blood transfusion was（224.0±72.7） ml. Hospitalization time was from 14 to 20 d with an average of 17.2 d. All patients were followed up from 6 to 18 months with an average of 14.1 months. The fracture healing time was from 3 to 6 months with an average of 3.1 months. One patient occurred internal fixation loosening and screw backward,4 cases occurred urinary tract infection,1 patient died of cardiovascular disease for 6 months postoperative,2 patients died of a stroke for 1 year postoperative. No incision deep infection,peri internal fixation fractures,lower extremity deep venous thrombosis,internal fixation breakage,nonunion,severe coax vara and coax valgus occurred. The final Harris score was 89.74±6.84,the result was excellent in 10 cases,good in 16 cases,fair in 4 cases,and poor in 2 cases. Conclusion：Locking PFP can provide relative stable fixation to proximal end of osteoporotic femoral fractures,which is a good choice for the treatment of intertrochanteric fractures. It could provide stableness of fractures and bone union,even avoid screws loose or slide out.
出处
《中国骨伤》
CAS
2016年第8期689-692,共4页
China Journal of Orthopaedics and Traumatology
基金
2013年浙江省自然科学基金(LY13H270004)
2011年浙江省教育厅高校科研基金资助项目(No.Y201121321)
2012年浙江省医学会项目(2012ZYC-A22)
国家中医药管理局"十二五"中医药重点学科建设资助项目([2012]32)~~
关键词
股骨骨折
转子间骨折
骨折固定术
内
骨质疏松
Femoral fractures
Intertrochanteric fractures
Fracture fixation
internal
Osteoporosis
