分次复位手术技术治疗老年股骨粗隆部骨折

发布时间：2018-09-04 07:03

【摘要】：[目的]探讨分次复位理念在手术治疗老年股骨粗隆部骨折中的效果。[方法]2009年6月~2013年10月,手术治疗老年股骨粗隆部骨折65例,其中男27例,女38例;年龄69~99岁,平均79岁。所有病例术前术后均详细评估,并存内科疾病者占83.08%,同时并存两种以上内科疾病者49.23%,以分次复位的理念应用Gamma3髓内钉治疗股骨粗隆间骨折,术中辅助单钩技术进行再次辅助复位,并应用改良的综合伴随疾病指数进行评估。术后常规进行下肢功能锻炼,术后6周、半年复查股骨正侧位X线片。[结果]所有病例均获随访,随访时间7~28个月(平均20个月);所有患者分别按髋关节功能评分标准评估,本组病例疗效满意、功能恢复好,65例中除1例术后1个月内并发心梗死亡外,其余患者骨折全部愈合,并发症发生率为16.92%。[结论]股骨粗隆间骨折多为高龄老人,常合并多种严重的内科疾病,外科治疗是首选。分次复位在老年股骨粗隆间骨折患者的手术治疗应用中可达到较好复位,临床效果满意。
[Abstract]:Objective: to evaluate the effect of fractional reduction in the treatment of femoral trochanter fracture in elderly patients. [methods] from June 2009 to October 2013, 65 cases of senile femoral trochanteric fractures were treated by operation, including 27 males and 38 females, with an average age of 79 years (69 ~ 99 years). All cases were evaluated in detail before and after operation, 83.08 cases were complicated with internal diseases and 49.23 cases with more than two kinds of internal diseases. Gamma3 intramedullary nail was used to treat intertrochanteric fracture of femur. Intraoperative assisted single hook technique was used to re-assist reduction and to evaluate with an improved comprehensive concomitant disease index. Functional exercise of lower extremity was performed routinely after operation. X-ray films of femur were performed 6 weeks and 6 months after operation. [results] all cases were followed up for 7 ~ 28 months (mean 20 months). Among 65 patients with functional recovery, except one patient who died of myocardial infarction within one month after operation, the fracture healed completely, and the complication rate was 16.92%. [conclusion] femoral intertrochanteric fractures are mostly elderly, often complicated with many serious internal diseases. Surgical treatment is the first choice. The results showed that the reduction of intertrochanteric fracture was satisfactory in the elderly patients with intertrochanteric fracture.
【作者单位】：南方医科大学第三临床医学院;海军总医院骨科;
【分类号】：R687.3

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