中国伤残医学
中國傷殘醫學
중국상잔의학
CHINESE JOURNAL OF TRAUMA AND DISABILITY MEDICINE
2014年
7期
1-2,3
,共3页
髋骨折%骨折固定术%内%骨板%老年人
髖骨摺%骨摺固定術%內%骨闆%老年人
관골절%골절고정술%내%골판%노년인
Hip fracture%Fracture fixation%Bone plate%The elderly
目的：探讨股骨近端万向锁定钢板内固定治疗老年人复杂股骨转子间骨折的临床疗效。方法：回顾性分析2011年1月～2013年1月应用股骨近端万向锁定钢板内固定治疗且获随访的42例老年股骨转子间骨折患者资料，男19例，女23例；年龄67～93岁，平均75．6岁。骨折根据AO分型：均为A3型，其中A3．1型12例，A3．2型14例，A3．3型16例。受伤至手术时间为3～7天，平均4．5天。记录手术时间、术中透视时间、住院天数、术中出血量及并发症等情况。末次随访时根据髋关节Harris评分标准评定疗效。结果：本组所有患者术后均获随访，平均18个月（12～30个月）；本组患者手术时间平均为58分（45～90分钟）；平均术中透视时间为156秒（60～280秒）；术中出血量平均为230mL（200～260 ml）；平均住院天数为14天（11～20天）；所有患者刀口均1期愈合，无1例发生切口延迟愈合或感染。术后1例发生下肢深静脉血栓形成，经治疗后痊愈。末次随访时根据髋关节Harris评分标准评定疗效：优23例，良15例，可4例，优良率为90．4％。本组患者无褥疮、肺炎、肺栓塞、股骨头缺血性坏死及骨折畸形愈合等并发症发生。结论：股骨近端万向锁定钢板内固定治疗老年人复杂股骨转子间骨折具有手术时间短、手术操作容易、固定安全可靠、术中出血少及患者能够早期进行功能锻炼等优点，临床疗效良好。
目的：探討股骨近耑萬嚮鎖定鋼闆內固定治療老年人複雜股骨轉子間骨摺的臨床療效。方法：迴顧性分析2011年1月～2013年1月應用股骨近耑萬嚮鎖定鋼闆內固定治療且穫隨訪的42例老年股骨轉子間骨摺患者資料，男19例，女23例；年齡67～93歲，平均75．6歲。骨摺根據AO分型：均為A3型，其中A3．1型12例，A3．2型14例，A3．3型16例。受傷至手術時間為3～7天，平均4．5天。記錄手術時間、術中透視時間、住院天數、術中齣血量及併髮癥等情況。末次隨訪時根據髖關節Harris評分標準評定療效。結果：本組所有患者術後均穫隨訪，平均18箇月（12～30箇月）；本組患者手術時間平均為58分（45～90分鐘）；平均術中透視時間為156秒（60～280秒）；術中齣血量平均為230mL（200～260 ml）；平均住院天數為14天（11～20天）；所有患者刀口均1期愈閤，無1例髮生切口延遲愈閤或感染。術後1例髮生下肢深靜脈血栓形成，經治療後痊愈。末次隨訪時根據髖關節Harris評分標準評定療效：優23例，良15例，可4例，優良率為90．4％。本組患者無褥瘡、肺炎、肺栓塞、股骨頭缺血性壞死及骨摺畸形愈閤等併髮癥髮生。結論：股骨近耑萬嚮鎖定鋼闆內固定治療老年人複雜股骨轉子間骨摺具有手術時間短、手術操作容易、固定安全可靠、術中齣血少及患者能夠早期進行功能鍛煉等優點，臨床療效良好。
목적：탐토고골근단만향쇄정강판내고정치료노년인복잡고골전자간골절적림상료효。방법：회고성분석2011년1월～2013년1월응용고골근단만향쇄정강판내고정치료차획수방적42례노년고골전자간골절환자자료，남19례，녀23례；년령67～93세，평균75．6세。골절근거AO분형：균위A3형，기중A3．1형12례，A3．2형14례，A3．3형16례。수상지수술시간위3～7천，평균4．5천。기록수술시간、술중투시시간、주원천수、술중출혈량급병발증등정황。말차수방시근거관관절Harris평분표준평정료효。결과：본조소유환자술후균획수방，평균18개월（12～30개월）；본조환자수술시간평균위58분（45～90분종）；평균술중투시시간위156초（60～280초）；술중출혈량평균위230mL（200～260 ml）；평균주원천수위14천（11～20천）；소유환자도구균1기유합，무1례발생절구연지유합혹감염。술후1례발생하지심정맥혈전형성，경치료후전유。말차수방시근거관관절Harris평분표준평정료효：우23례，량15례，가4례，우량솔위90．4％。본조환자무욕창、폐염、폐전새、고골두결혈성배사급골절기형유합등병발증발생。결론：고골근단만향쇄정강판내고정치료노년인복잡고골전자간골절구유수술시간단、수술조작용역、고정안전가고、술중출혈소급환자능구조기진행공능단련등우점，림상료효량호。
Objetcive:To study the femoral proximal universal locking plate internal fixation to treat the elderly the clinical curative effect of complex femoral fractures between rotor .Methods:A retrospective analysis in January 2011 to January 2013 application of proxi-mal femur universal treatment and locking plate internal fixation for follow -up data of 42 cases of elderly patients with femoral fractures between rotor, (19 male and female 23 cases;67 ~93 years old, average 75.6 years.Fracture according to AO classification:are the A3 type, including 12 cases A3.1 type, type A3.2 14 cases, 16 cases of A3.3 type.Injury to the surgery time is 3 to 7 d, 4.5 d.Record the operation time , intraoperative fluoroscopy time , hospitalization days , intraoperative blood loss and complication , and so on and so forth.According to the Harris hip score standard at the time of the last follow -up evaluation curative effect .Results: All patients with postoperative follow-up, an average of 18 months (12 ~30 months);This group of patients with surgery for an average of 58 min (45~90 min);The average intraoperative fluoroscopy time of 156 s (60 ~280 s);Intraoperative blood loss , an average of 230 ml (200 ~260 ml);The average hospitalization days for 14 d (11 ~20 d);All patients blade are primary healing , no case of delayed healing of in-cision or infection .Postoperative deep vein thrombosis of lower limb , and one recovered after treatment .According to the Harris hip score standard at the time of the last follow -up evaluation curative effect:23 cases, 15 cases, 4 cases, fine rate was 90.4%.This group of pa-tients without bedsore , pneumonia , pulmonary embolism , ischemic necrosis of femoral head and complications such as fracture malunion . Conclusion:proximal femoral universal locking plate internal fixation to treat the elderly complex femoral fractures between the rotor has a shorter operation time , easy operation , safe and reliable fixation , intraoperative patients with less bleeding and can carry on the advantages of functional exercise early , clinical curative effect is good .
