| 高龄股骨转子间骨折两种治疗方法的临床观察 |
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Received:October 24, 2006
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| 作者 | Author | 单位 | Unit | E-Mail |
| 陈继平 |
CHEN Ji-ping |
徐州市中医院骨科,江苏徐州221003 |
The TCM Hospital of Xuzhou,Xuzhou 221003,Jiangsu,China |
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| 何秉辉 |
HE Bing-hui |
徐州市中医院骨科,江苏徐州221003 |
The TCM Hospital of Xuzhou,Xuzhou 221003,Jiangsu,China |
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| 杨六中 |
YANG Liu-zhong |
徐州市中医院骨科,江苏徐州221003 |
The TCM Hospital of Xuzhou,Xuzhou 221003,Jiangsu,China |
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| 时超 |
SHI Chao |
徐州市中医院骨科,江苏徐州221003 |
The TCM Hospital of Xuzhou,Xuzhou 221003,Jiangsu,China |
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| 王喜安 |
WANG Xi-an |
徐州市中医院骨科,江苏徐州221003 |
The TCM Hospital of Xuzhou,Xuzhou 221003,Jiangsu,China |
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| 期刊信息：《中国骨伤》2007年20卷，第8期，第519-521页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:探讨手术治疗高龄股骨转子间骨折的安全性、合理性。
方法:股骨转子间骨折患者65例,其中采用动力髋螺钉（DHS）治疗32例,男14例,女18例;年龄6579岁,平均（70.6±2.3）岁;EvansⅠ型2例,Ⅱ型7例,Ⅲ型15例,Ⅳ型8例。采用单边外固定支架治疗33例,男14例,女19例;年龄6890岁,平均（74.2±3.8）岁;EvansⅠ型3例,Ⅱ型15例,Ⅲ型11例,Ⅳ型1例,Ⅴ型3例。临床观察包括术中出血量、手术时间、骨折愈合时间、术后并发症及髋部运动功能等。
结果:所有病例均获随访,时间134个月,平均19个月。两组手术时间、术中出血量、术后并发症发生率差异有统计学意义（P<0.05）。平均愈合时间DHS组为（13.0±2.7）周,外固定支架组为（12.3±3.0）周,差异无统计学意义。Sanders髋关节功能评价:DHS组优19例,良6例,可3例,差2例;外固定支架组优12例,良8例,可8例,差5例。两组优良率差异有统计学意义（P<0.05）。
结论:围手术期外固定支架组较DHS组安全简便,术后疗效DHS组优于外固定支架组。 |
| [关键词]:股骨转子间骨折 骨折固定术 动力髋螺钉 外固定 老年人 |
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| Clinical observation of two kinds of treatment for aged patients with intertrochanteric fracture of femur |
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Abstract:
Objective:To explore the safe and rationality of the surgical treatment for intertrochanteric femoral fracture in aged.
Methods: Sixty-five aged patients with intertrochanteric fracture were treated with two different methods.Among them,32 cases were performed by dynamic hip screw (DHS),involving 14 male and 18 female with an average age of (70.6±2.3) years (ranged 65 to 79).According to Evans typing,there were 2 cases of type Ⅰ,7 of type Ⅱ,15 of type Ⅲ and 8 of type Ⅳ.Thirty-three cases were treated by external fixator,involving 14 male and 19 female with an average age of (74.2±3.8) years (ranged 68 to 90).According to Evans typing,there were 3 cases of type Ⅰ,15 of type Ⅱ,11 of type Ⅲ,1 of type Ⅳ and 3 of type Ⅴ.To observe the blooding,the operation time,the union time of fracture,post-operative restored function and complications.
Results:All patients were followed-up for 1 to 34 months (mean 19 monts).There were significant differences in the operation time,the blooding and the complications between the two different treatments (P<0.05).The mean healing time of DHS was (13.0±2.7) weeks and external fixator was 12.3 weeks,there was not a significant difference between two groups(P>0.05).According to Sanders′ standard,in DHS group the result was excellent in 19 cases,good in 6,fair in 3 and poor in 2. In external fixator group the result was excellent in 12 cases,good in 8,fair in 8 and poor in 5.There was a significant difference in the excellent and good recover rate between two groups (P<0.05).
Conclusion: It is safe and easy to treat aged patients with intertrochanteric fracture using external fixator in period around surgery,but comparing with DHS group the curative effect is poorer. |
| KEYWORDS:Intertrochanteric fracture of femur Fracture fixation Dynamic hip screw External fixators 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: | 陈继平,何秉辉,杨六中,时超,王喜安.高龄股骨转子间骨折两种治疗方法的临床观察[J].中国骨伤,2007,20(8):519~521 |
| 英文格式: | CHEN Ji-ping,HE Bing-hui,YANG Liu-zhong,SHI Chao,WANG Xi-an.Clinical observation of two kinds of treatment for aged patients with intertrochanteric fracture of femur[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(8):519~521 |
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