| 改良微创DHS内固定治疗老年股骨粗隆间骨折480例分析 |
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投稿时间：2012-10-08
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| 期刊信息：《中国骨伤》2013年，第26卷，第4期，第340-343页 |
| DOI：10.3969/j.issn.1003-0034.2013.04.019 |
| 基金项目: |
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中文摘要:
目的: 探讨改良微创DHS内固定治疗老年股骨粗隆间骨折及该术式对股骨粗隆外侧壁的影响。
方法: 回顾分析2005年1月至2010年12月采用改良微创DHS内固定治疗老年股骨粗隆间骨折480例, 男212例, 女268例, 年龄60～103岁, 平均78.3岁。按Evans骨折分型:I型166例, Ⅱ型212例, Ⅲ型86例, Ⅳ型16例, 其中外侧壁危险型粗隆间骨折46例。观察记录手术切口长度、术中出血量、手术中延长切口套入侧板到闭合切口时间及术后发生的并发症。在术后1、3、6个月进行随访, 按影像学评定指标及临床疗效指标进行评定。
结果: 手术切口长度平均(8.0±1.2)cm,术中出血量平均为(150.0±6.4) ml,手术中延长切口套入侧板到闭合切口时间平均为(22.0±1.3) min,术后外侧壁破裂1例, 拉力螺钉在股骨头内切出3例, 过度退缩4例。术后6个月基本日常生活能力(BADL)(14.8±1.1)分, 步行活动能力(6.40±0.34)分。
结论: 改良微创DHS内固定手术方式治疗老年股骨粗隆间骨折手术创伤小, 伤口暴露时间短, 术中出血量少, 术后能很好地维持外侧壁的完整性, 术后基本日常生活能力及行走活动能力恢复较理想, 临床疗效满意。 |
| 【关键词】股骨骨折 骨折固定术,内 外科手术 老年人 |
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| Improved minimally invasive DHS internal fixation for old age patients with intertrochanteric fractures |
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ABSTRACT
Objective: To discuss the improved minimally invasive DHS fixation for treatment of intertrochanteric fractures in aged and the influence on the lateral wall of the femoral.
Methods: From January 2005 to December 2010,480 aged patients with intertrochanteric fractures were treated by modified minimally invasive DHS fixation. There were 21 males and 268 females,with an average age of 78.3 years old ranging from 60 to 103 years. Aaccording to the Evans type,there were 166 cases of type I,212 of type Ⅱ, 86 of type Ⅲ, 16 of type Ⅳ, among them 46 cases had the dangerous fractures of the lateral wall. The incision length,blood loss volume,time from extending surgical incision in the side panel to close and postoperative complications were observed and recorded. At 1 month,3 and 6 months after operation,the patients were followed-up,the outcome were evaluated according to the imaging evaluation index and clinical effect assessment indexes.
Results: The surgical incision length averaged (8.0±1.2) cm,peri-operative bleeding averaged (150.0±6.4) ml,time from extending the incision in the operation to close incision averaged (22.0±1.3) min,1 case had postoperative rupture of the external wall,and 3 cases had tension screw cut out in the femoral head,4 cases had excessive shrink back. Postoperative 6 months basic daily living skills (BADL) averaged (14.8±1.1) scores,and the ability of walk averaged (6.40±0.34) scores.
Conclusion: Improved minimally invasive DHS fixation for treatment of intertrochanteric fractures in aged had advantages of small trauma surgery,short wound exposure time,less peri-operative bleeding and the integrity of the lateral wall after operation,the basic daily living skills and ability to walk has an ideal recovery activities,satisfied clinical curative effect. |
| KEY WORDS Femoral fractures Fracture fixation,internal Surgical procedures,operative Aged |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 张卫红,张军波.改良微创DHS内固定治疗老年股骨粗隆间骨折480例分析[J].中国骨伤,2013,26(4):340~343 |
| 英文格式: | ZHANG Wei-hong,ZHANG Jun-bo.Improved minimally invasive DHS internal fixation for old age patients with intertrochanteric fractures[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(4):340~343 |
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