DHS联合拉力螺钉内固定治疗老年股骨粗隆间骨折探析.docVIP

DHS联合拉力螺钉内固定治疗老年股骨粗隆间骨折探析[摘要] 目的：探讨DHS联合拉力螺钉治疗老年股骨粗隆间骨折的临床疗效。方法：采用DHS联合拉力螺钉内固定治疗老年股骨粗隆间骨折治疗34例。结果：平均随访13个月，34例骨折全部愈合。1例出现轻度髋内翻，3例患肢短缩在1.0～1.5 cm，均能独立步行，生活自理。21例已取出内固定，余13例患者因高龄而放弃内固定取出。结论：DHS与拉力螺钉进行老年股骨粗隆间骨折内固定治疗，手术较简单，稳定性好，是临床治疗老年股骨粗隆间骨折的一种合理选择。 [关键词] 股骨粗隆间骨折；DHS 拉力螺旋；内固定 [中图分类号]R683 [文献标识码]C [文章编号]1673-7210（2008）05（c）-184-02 Discuss of treatment with DHS and tensile screw for old geriatric femoral intertrochanteric fracture YANG Ai-yong,GUAN Qin-qiang,LIN Chuan-song,HUANG Shuo,RAO Ming-liang (Siqian Town Hospital of Xinhui District of Jiangmen, Jiangmen 529159,China) [Abstract] Objective:To discuss clinical effects of treatment with DHS and tensile screw for the old geriatric femoral intertrochanteric fracture. Methods: 34 cases of the patients with geriatric femoral intertrochanteric fracture were received DHS and tensile screw. Results: 34 cases were all healed and they were followed up for 13 months on the average. There was only one case which was coxa vara in light degree; there were three cases whose limbs were shortened for 1.0~1.5 cm. But they can walk independently and take care of themselves. 21 cases had been taken out of internal fixations and other 13 cases gave up for the old age. Conclusion: The treatment with DHS and tensile screw for the old geriatric femoral intertrochanteric fracture is a reasonable selection in the clinical because the operation is simple and the stability is good. [Key words] Femoral intertroehanteric fracture； DHS tensile screw； Internal fixation 股骨粗隆间骨折是老年人常见骨折，随着社会人口的老龄化及平均寿命的延长，这种骨折的住院病例明显增加，有效治疗老年粗隆间骨折，对提高患者生存质量，减轻家属护理负担，降低死亡率，具有重要意义。笔者2003年9月～2007年2月，对34例老年粗隆间骨折患者采用DHS联合拉力螺钉内固定治疗，获得满意效果。 1 资料与方法 1.1 一般资料 老年粗隆间骨折病例34例， 其中，男16例，女18例，年龄60～70岁8例，71～80岁23例，81～86岁3例，平均74.5岁。致伤原因：平地走路跌倒6例，上下楼梯跌倒9例，卫生间滑倒13例，被自行车或摩托车撞倒6例。入院时间为伤后1～12 ｄ，平均5 d。按骨折Evans分类：Ⅰ型3例，Ⅱ型9例，Ⅲ型17例，Ⅳ型2例，Ⅴ型3例。术前合并慢性支气管炎7例，高血压、冠心病8例，糖尿病3例。 1.2 手术方法 入院后常规术前检查，有并发症患者请相关科室会诊治疗。术前皮肤牵引制动，摄双髋关节正位片和患侧股骨全长片，了解对侧髋关节和患侧股骨情况，3～10 d后进行手