动力髋螺钉与股骨近端锁定板治疗高龄粗隆间骨折的疗效分析

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1、动力髋螺钉与股骨近端锁定钢板治疗高龄粗隆间骨折的疗效分析严清理张本其桂春生（安徽省池州市第二人民医院骨科，安徽池州247000）摘要背景：动力髋螺钉一度被认为是治疗股骨粗隆间骨折的“金标准”，随着内固定的发展，固定粗隆间骨折的方式有多种，另外一种临床多用的是股骨近端锁定钢板。目的：评价动力髋螺钉（DHS）与股骨近端锁定钢板治疗高龄股骨粗隆间骨折患者的临床疗效。方法：总结我科自2007-5/2012-5收治的65岁以上高龄股骨粗隆间骨折患者共45例，随机采用动力髋螺钉与股骨近端锁定钢板手术治疗。按照Evans分型方法进行骨折分型，分析两组病人手术失血量、手术

2、时间、切口长度及术后并发症、关节功能恢复情况。结果与结论：DHS组与锁定钢板组临床疗效的优良率分别为80.6%、81.4%,两组手术时间、切口长度以及失血量统计学无显著差异（P>0.05)。但锁定钢板组手术时间、失血量较DHS组有减少趋势。随着手术技术与技巧的改进，DHS和股骨近端锁定钢板治疗高龄股骨粗隆间骨折，后者较前者在获得即刻稳定与远期并发症方面具有更好的优势，且在高龄骨质疏松患者中更明显。关键词：粗隆间骨折高龄动力髋螺钉近端锁定钢板骨质疏松DynamicHipScrewVsLockingCompressionPlateForTreatmentOfI

3、ntertrochantericFracturesInElderlyPatientsYANQing--li,ZHANGBen-qi,GUIChun-sheng(Orthopaedicthe2thHospital,ChizhouAnhuiChina）Abstract:Background:Dynamichipscrewhasbeensupposedtobethegoldstandardfortreatmentofintertrochantericfractures,withthedevelopmentofinternalfixation，therearela

4、rgenumbersofmethodstofixintertrochantericfractures,anotherinternalfixationisLockingCompressionPlate,whichiswidelyusedinclinical.Objective:Toevealuatetheshort-termoutcomeofDHSandLockingCompressionPlateinthetreatmentofintertrochantericfracturesduetotraumafortheicationOld--yearsPatie

5、nts.Methods:Atotalof45patientswithintertrochantericfractureswererandomlydividedintoDHSgroupandLockingCompressionPlategroupduringMay-2007toMay-2012.ThefracturesweredivdedaccordingtoEvansClassfication.Theintra-operativebloodloss,operationtime,lenthofincision,andpost-operationcomplic

6、ationswereanalyzed.ResultsandConclusion:TheexcellentandgoodratesofpatientoutcomesinDHSGroupandLockingCompressionPlateGroupwere80.6%and81.4%.Respectively(P>0.05).AlthoughtheoperationtimeandbloodlosshadadecreasingtendencyintheLockingPlategroup.ConclutionWiththematurationoftechnique,

7、DHSandLockingCompressionPlatehavesimilarefficaciesintreatmentofintertrochantericfracturesinelderlypatients.ButLockingCompressionPlatehasashorteroperation-time,lessbloodloss,andshouldbethefirstchoicefortheelderlyosteoporoticintertrochantericfracturepatients.Keywords:intertrochanter

8、icfracture;Elderly;DynamicHipScre