CAJ | 학술논문

目的对老年转子间骨折手术方式选择的长期疗效随访并分析.方法分析安阳市三个市级医院骨科2005至2009年手术治疗的老年转子间骨折402例,参照Singh指数分型方法的分类法指导选择骨水泥型人工股骨头置换术、内固定术实施治疗,其中Ⅰ型骨折17例(4％),Ⅱ型骨折49例(12％),Ⅲ型骨折287例(72％),Ⅳ型骨折48例(12％).应用针对性的生活动作功能评分随访术后1～5年,统计骨科并发症、康复时间和功能评分结果.结果骨折分型指导术式选择治疗,术后多数患者术后1个月恢复自理.术后3个月及1年关节功能随访优良率分别为:Ⅰ型为70.6％和100.0％;Ⅱ型内固定为57.9％和89.4％,Ⅱ型关节置换为85.7％和86.7％;Ⅲ型为85.4％和92.0％;Ⅳ型为72.9％和87.5％.Ⅱ型骨折内固定失败2例(5％),关节置换感染6例(1.9％).5年随访未发现髋臼过度磨损、假体松动等远期并发症.结论合理的手术方式选择可以显著降低术后内固定术失败率,缩短康复周期,远期随访结果满意.
목적 대노년전자간골절수술방식선택적장기료효수방병분석.방법 분석안양시삼개시급의원골과2005지2009년수술치료적노년전자간골절402례,삼조Singh지수분형방법적분류법지도선택골수니형인공고골두치환술、내고정술실시치료,기중Ⅰ형골절17례(4％),Ⅱ형골절49례(12％),Ⅲ형골절287례(72％),Ⅳ형골절48례(12％).응용침대성적생활동작공능평분수방술후1～5년,통계골과병발증、강복시간화공능평분결과.결과 골절분형지도술식선택치료,술후다수환자술후1개월회복자리.술후3개월급1년관절공능수방우량솔분별위:Ⅰ형위70.6％화100.0％;Ⅱ형내고정위57.9％화89.4％,Ⅱ형관절치환위85.7％화86.7％;Ⅲ형위85.4％화92.0％;Ⅳ형위72.9％화87.5％.Ⅱ형골절내고정실패2례(5％),관절치환감염6례(1.9％).5년수방미발현관구과도마손、가체송동등원기병발증.결론 합리적수술방식선택가이현저강저술후내고정술실패솔,축단강복주기,원기수방결과만의.
Objective To conduct long-term follow-ups on the efficacies of surgical approaches for intertrochanteric fractures in elder patients.Methods The outcomes of intertrochanteric fractures in 402 elder patients undergoing different surgical procedures during 2005 to 2009 were reviewed.The modified classification of Singh index,detailed surgical contraindications and improved functional scoring system specialized for intertrochanteric fracture were included.Among these,type Ⅰ to Ⅳ had 17 cases (4％),49 cases ( 12％ ),187 cases (72％),48 cases ( 12％ ).The follow-up period was 1 - 5 years.The orthopedic complications,rehabilitation duration and functional scores were reviewed.Results Most patients achieved self-care at 1 month post-operation.The failure rate of internal fixation was 5％ and infection rate 1.9％ in hemiarthroplasty.type Ⅰ to Ⅳ had 70.6％ and 100.0％,85.7％ and 86.7％,85.4％ and 92.0％,72.9％and 87.5％ cases showed excellent or good outcomes at 3 month and 1 year.During a follow-up period of 5 years,there was no occurrence of prothetic loosening or excessive wear of acetabular.Conclusion A rational selection of surgical approaches may markedly reduce the failure rate of internal post-operative fixation and shorten the rehabilitation period.And the long-term follow-up outcomes are satisfactory.