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1、高龄患者股骨粗隆间骨折手术治疗体会作者：李凡，黄建华，陶杰，李豪青，曹云［摘要］目的探讨高龄患者股骨粗隆间骨折的手术方法及疗效。方法对XX年1月～XX年2月收治的高龄(75岁以上)股骨粗隆间骨折44例患者进行手术治疗。其中男15例,女29例,年龄75～93岁,90岁以上4例,平均年龄82岁。44例中有38例合并有内科疾病,占病例总数的%。44例均采用Gamma钉内固定治疗。结果4例病例经围术期准备后均顺利进行了手术,术后死亡1例,余43例均得到随访。随访时间5～18个月,平均11个月。骨折全部愈合,愈合时间3～6个
2、月。无明显髋内翻及下肢短缩畸形，无感染,无Gamma钉断裂、退钉。患肢关节功能优良率93%。结论高龄股骨粗隆间骨折患者常合并多种内科疾病,身体状况差,对手术耐受性也较差。Gamma钉具有手术操作简单、时间短、固定牢靠、损伤小、出血少、骨折愈合率高等优点,适合高龄股骨粗隆间骨折患者的手术要求,是一种值得临床推广的手术方法。［关键词］股骨粗隆间骨折；高龄患者；内固定术Surgicalexperiencesofthefemoralintertrochantericfracturesoftheagedpeople［Abst
3、ract］ObjectiveTodiscussthesurgicalmethodandefficacyofthefemoralintertrochantericfracturesoftheagedFromJan,200toFeb,XX,4patients(morethanyrs)withthefemoralintertrochantericfracturesweresurgicallythem,therewere1maleandfemalepatients,andtheagerangevariedfromtoyrs
4、(theaverageagewasyrs,alsopatientswasmorethan0yrs).3patients(%)ofallaccompaniedbyotherinternalmedicaldisorders,andthetreatmentofallpatientswereselectedwithGammaAfterperi-operativepreparations,4patientsweresuccessfullyoperated.Butonepatientsdiedafteroperation,an
5、dotherpatientswerefollowedupforto1monthspost-operations(meantimewas11months).Thefracturesofpatientswithfemoralintertrochantericfractureswerehealedbetweentomonthsafter,therewerenocomplicationsoccurred:suchashipvarus,shorteningoflowerextramity,infections,breakof
6、Gammanails,orwithdrawoffunctionsofhipjointswasexcellentandgoodattheratioof3%.ConclusionTheagedpeoplewiththefemoralintertrochantericfracturesusuallyaccompaniedwithseveralinternalmedicaldisorders,andthEirgeneralconditionswerepoorandthetoleranceofoperationswasnot
7、good.However,thetechniquesofGammanailswassimple,withshorttime,offirmfixation,minimalinjury,lessbleedings,andwithhighratioofbonyitwasverysuitableforthefemoralintertrochantericfractureoftheagedpeople,andworthfulforrecommendationofsurgery.［Keywords］intertrochante
8、ricfracture;elderly;internalfixation随着人口老龄化时代的到来以及老年骨质疏松疾病的日益严重,老年股骨粗隆间骨折发生率呈逐年上升趋势,而且发病年龄也在升高。老年人多患有一种或者多种内科疾病,保守治疗死亡率较高,现多主张早期手术治疗［1］。XX年1月～XX年2月我们对44例75岁以上高龄股骨粗隆间骨折患者进行手术治疗,均采用G
