DHS内固定治疗老年骨质疏松性股骨转子间骨折及其并发症分析.doc

DHS内固定治疗老年骨质疏松性股骨转子间骨折及其并发症分析 　　【摘要】目的探讨DHS内固定治疗老年骨质疏松性股骨转子间骨折的疗效及其并发症分析。方法对2000年1月至2005年1月采用DHS治疗骨质疏松性股骨转子间骨折48例患者进行回顾性分析。结果随访48例，随访时间9～30个月，平均16个月。按Sadowski法评价疗效，优23例，良20例，可2例，差3例，优良率为89.6％。结论DHS内固定治疗骨质疏松性股骨转子问骨折的疗效好、并发症少。可提高患者生存质量。 　　【关键词】动力髋关节螺钉； 股骨转子间骨折； 骨质疏松症 　　 　　Clinical research for the treatment fracture of osteoporotic femoral intertrochanteric with DHS in aged patientsYUAN Ze-lue,Wang Wan-hong.Department of Surgery, Public Health Center of Dazhiping Town, Badong County; Department of Orthopedics, First Peoples Hospital of Yichang City, Hubei Province, yichang 444322,China 　　【Abstract】ObjectiveTo investigate the therapeutic effects on the osteoporotic femoral intertrochanteric fracture with DHS in aged patients． MethodsFrom January 2000 to January 2005， 48 cases with osteoporotic femoral intertrochanteric fracture received internal fixation of DHS were analyzed retrospectively．ResultsA total of 48 patients were followed．The time of followed up was from 9 to 30 months，and the average was 16 months．These aged patients were assessed to hip function according to Sadowski score．There were excellent 23 cases, good 20,fair 2,poor 3 in this group．The rates of choiceness is 89.6％ ．ConclusionInternal fixation of DHS possesses good therapeutic effect and less complication for treating osteoporotic femoral intertrochanteric fracture．And it can improve patients quality of life． 　　【Key words】Dynamic hip screw；Intertrochanteric fracture；Osteoporosi 　　 　　股骨转子间骨折多发生于骨质疏松性老年人，特别是70岁以上的高龄患者。传统的非手术治疗方法是卧床牵引，但长期卧床易引起褥疮、尿路感染、肺部感染、下肢深静脉血栓形成等并发症，甚至导致死亡；同时骨折畸形愈合的发生率也较高。因此，在无严重内科疾病而能耐受手术的情况下应积极手术治疗以改善髋关节的功能,提高生存质量。作者自2000年1月至2005年7月期间共采用动力髋螺钉(dynamic hip screw，DHS)内固定治疗48例70岁以上高龄患者股骨转子间骨折，取得良好疗效。 　　 　　1临床资料与方法 　　 　　1．1一般资料本组48例，男26例，女22例。年龄70～92岁，平均80.8岁。创伤原因:跌伤38例，交通意外伤10例。术前病程1～12 d．平均4.3 d。根据患者术前骨盆X线片，采用Singh指数评估转子部骨质疏松程度，小于V级表明有程度不等的骨质疏松[1]。本组患者Singh指数小于V级，结合临床，表明存在不同程度的骨质疏松。骨折类型参照股骨转子间骨折Evans分型标准[2]：I型17例，Ⅱ型24例，ⅢA型4例，ⅢB型2例，Ⅳ1例。合并有糖尿病10例，高血压病21例，合并慢性支气管炎、肺气肿10例，有脑