摘要:目的:探討老年人股骨粗隆間骨折不同手術方式的選擇。方法:我院2004年1月至2007年12月間應用不同術式治療老年股骨粗隆間骨折110例,其中動力髖螺釘(DHS)25例, 股骨近端髓內釘(PFN)41例,人工股骨頭置換44例。術后所有患者均獲隨訪,平均12.6個月。對術后并發癥和按照Kuderna 改良 Merli D’Aubigne標準得到的髖關節功能恢復優良數(率)進行評價。結果:術后出現并發癥3例,其中PFN術式2例;人工股骨頭置換術式1例。圍手術期內無傷口感染,無死亡病例。三種術式總體優良數(率)為:107(97.3%)。結論:三種手術方式各有其優缺點,沒有一種術式能普遍適用于各種類型粗隆間骨折,臨床上,為了最大限度降低手術風險,我們沒有必要專注或偏好于某一種手術方式,要根據患者的個體差異及每種術式的優缺點,靈活地為每例股骨粗隆間骨折患者制定出其最適宜的手術方式,大都能取得滿意的療效。
Abstract: Objective: To investigate the chosen of 3 different surgical methods in the treatment of intertrochanteric femoral fractures in the elderly. Methods:From January, 2004 to December, 2007, 110 cases with the femoral intertrochanteric fractures in the elderly were treated with the followed 3 kinds of operations respectively:dynamic hip screw (25 cases), proximal femoral nail (41 cases), hip hemiarthroplasty (44 cases). After surgery all patients were followed up; Followedup period range from 6 months to 18 months(average 12.6 months). The good and excellent number (rate) of 3 surgical methods with Merli D’Aubigne evaluation criteria were evaluated, and compared in the postoperative complications. Results: 3 complications occurred postoperatively ( 2 with PFN,1 with hip hemiarthroplasty), none wound infection or died in Perioperatie. The total good successful number (rate) was 107(97.3%). Conclusion:Each has its advantages and its disadvantages. None of three kinds of surgical methods can be used generally all kinds of the femoral intertrochanter fracture. In clinical work, we don not need to focus on or prefer to the only one of them in order to minimize the risk. The good response to treatment will be get if we can choose the appropriate method according to the individual differences of the advantages and disadvantages of each method.

Citation： LI Wei,HU Daoqing,REN Xianhai.. Three Different Surgical Methods in the Treatment of the Femoral Intertrochanter Fracture of the Elderly. West China Medical Journal, 2009, 24(11): 2957-2960. doi: Copy

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