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老年股骨粗隆间骨折不同分型的内固定治疗选择
Hits: 2272   Download times: 1281   Received:October 30, 2007    
作者Author单位UnitE-Mail
蓝海 LAN Hai 海南省农垦那大医院骨科,海南 儋州 571700 Department of Orthopaedics,the Nongken Nada Hospital of Hainan,Danzhou 571700,Hainan,China  
期刊信息:《中国骨伤》2008年21卷,第7期,第532-533页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:探讨老年股骨粗隆间骨折不同分型内固定治疗选择。

方法:老年股骨粗隆间骨折62例,男40例,女22例;年龄60~82岁,平均71岁。按Evans分型:Ⅰ型16例,Ⅱ型13例,Ⅲ型17例,Ⅳ型10例,Ⅴ型6例。其中Ⅰ、Ⅱ型29例采用空心钉内固定治疗,Ⅲ、Ⅳ、Ⅴ型33例采用动力加压髋螺钉治疗(DHS)治疗。

结果:经1~4年随访,平均2.5年,根据疗效评定的标准,Evans Ⅰ、Ⅱ型(即稳定型骨折)29例,优13例,良11例,差5例;Evans Ⅲ、Ⅳ、Ⅴ型(即不稳定型骨折)33例,优18例,良12例,差3例。

结论:老年股骨粗隆间骨折不同的分型,分别采用了两种不同的内固定治疗,对EvansⅠ、Ⅱ型的稳定性骨折,多采用了空心钉内固定的治疗,而对Evans Ⅲ、Ⅳ、Ⅴ的不稳定性骨折,则以动力加压髋螺钉(DHS)内固定为首选。
[关键词]:股骨骨折  骨折固定术,内  外科手术,选择性
 
Treatment of different types of intertrochanteric fractures in the elderly with internal fixation
Abstract:

Objective: To study the treatment for the different types of intertrochanteric fractures in the elderly with internal fixation.

Methods: There were 62 cases of intertrochanteric fractures in the elderly(40 male and 20 female,aged fom 60 to 82 years,with an average age of 71 years). According to typing of Evans:there were 16 type Ⅰ,13 typeⅡ,17 type Ⅲ,10 type Ⅳ and 6 type Ⅴ。 Internal fixation with three cannulated screws was applied for the 29 cases of typeⅠ and type Ⅱ, with dynamic compression hip screw(DHS) for 33 cases of typeⅢ,Ⅲand V.

Results: After 1 to 4 years follow up (mean 2.5 years),according to the criteria of curative effect,13 of 29 cases of typeⅠ andⅡ(stable fracture) were excellent,11 good and 5 poor,18 of 33 cases of typeⅢ,Ⅳ and Ⅴ(unstable fracture) were excllent,12 good and 3 poor.

Conclusion: Two different internal fixations can be used for different types of intertrochanteric fracture in the elderly. The internal fixation by three cannulated screws is often applied. for the stable fracture (typeⅠand Ⅱ). For the unstable fracture (type Ⅲ,Ⅳ and Ⅴ),internal fixation with dynamic compression hip screw (DHS) is the first selection.
KEYWORDS:Femoral fractures  Fracture fixation,internal  Surgical procedures,elective
 
引用本文,请按以下格式著录参考文献:
中文格式:蓝海.老年股骨粗隆间骨折不同分型的内固定治疗选择[J].中国骨伤,2008,21(7):532~533
英文格式:LAN Hai.Treatment of different types of intertrochanteric fractures in the elderly with internal fixation[J].zhongguo gu shang / China J Orthop Trauma ,2008,21(7):532~533
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