文档介绍：股骨近端外侧加压锁定板内固定治疗高龄患者股骨粗隆间骨折34例报告
李裕标郭乃铭徐海涛罗筱玮黄梦全赖秋练
广州解放军第458医院骨科
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摘    要:
目的探讨骨折部植骨、股骨近端外侧加压锁定板内固定治疗高龄股骨粗隆间骨折患者的疗效。方法对20132015年我院收治的34例高龄股骨粗隆间骨折患者, 采用骨折部植骨、股骨近端外侧加压锁定板内固定进行治疗。对骨折愈合、并发症、关节功能等指标进行统计观察。结果本组均获124个月随访, 3例分别于术后1个月、4个月和6个月因肺部感染死亡, 29例骨折愈合, 2例骨折不愈合。Harris髋关节评分系统评分≥90分13例, 7090分15例, 4070分3例, 平均(±) 分。结论采用骨折部植骨, 股骨近端外侧加压锁定板内固定的方法治疗高龄股骨粗隆间骨折, 临床疗效良好。重视合并症的治疗, 有效防范严重并发症的发生, 保证手术安全, 有效降低围手术期及术后病死率。
关键词:
股骨粗隆间骨折; 股骨锁定钢板; 高龄; 内固定; 植骨;
收稿日期:2016-12-03
Clinical effects on senile patients with femoral intertrochanteric fractures: report of 34 cases
LI Yu-biao GUO Nai-ming XU Hai-tao LUO Xiao-wei HUANG Meng-quan LAI Qiu-lian
Department of Orthopaedics, PLA 458th Hospital;
Abstract:
Objective To investigate clinical effects of locking proximal femoral plate ( LPFP) with bone grafting for femoral intertrochanteric fracture in elderly patients. Methods Thirty-four patients with femoral intertrochanteric fractures, treated with LPFP and bone grafting, were retrospective analyzed. Fracture healing time, plications and joint function recovery were observed. Results All patients got regular follow-up from 1 to 24 months. Three patients died of lung infections at 1, 4, 6 months postoperatively. Twenty-nine patients got clinical healing, while nonunion occurred in 2 patients. Harris score: ≥90 in 13 patients, 70-90 in 15 patients, 40-70 in 3 patients, on average ( ± ) . Conclusions LPFP with bone grafting is effective in the treatment of femoral intertrochanteric fracture in elderly patients. Management plications should be emphasized to lower the mortality rate perioperatively and postoperatively.
Keyword:
Femoral intertrochanteric fracture; Locking proximal femoral plate; Senile patients; Internal fixation; Bone grafting;
Received: 2016-12-03
老年股骨粗隆间骨折在创伤骨科中较为常见, 随着社会老龄化进程的加快, 其发病率逐渐升高。高龄患者身体状况差, 脏器功能弱, 合并疾病多, 长期卧床导致并发症的发生, 病死率高[1], 目前早期手术治疗并进行术后功能锻炼是治疗老年股骨粗隆间骨折