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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2003年1月～2006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86.3%。44例均采用Gamma钉内固定治疗。结果44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个月。无明显髋内翻及下肢短缩畸形，无感染,无
2、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［Abstract］ObjectiveTodiscussthesurgicalmethodandeffic
3、acyofthefemoralintertrochantericfracturesoftheagedpeople.MethodsFromJan,2003toFeb,2006,44patients(morethan75yrs)withthefemoralintertrochantericfracturesweresurgicallytreated.Amongthem,therewere15maleand29femalepatients,andtheagerangevariedfrom75to93yrs(theaverageagewas82yrs,also4patientswa
4、smorethan90yrs).38patients(about86.3%)ofallaccompaniedbyotherinternalmedicaldisorders,andthetreatmentofall44patientswereselectedwithGammanails.ResultsAfterperi-operativepreparations,44patientsweresuccessfullyoperated.Butonepatientsdiedafteroperation,andother43patientswerefollowedupfor5to18
5、monthspost-operations(meantimewas11months).Thefracturesof43patientswithfemoralintertrochantericfractureswerehealedbetween3to6monthsafteroperations.Meanwhile,therewerenocomplicationsoccurred:suchashipvarus,shorteningoflowerextramity,infections,breakofGammanails,orwithdrawofnails.Thefunction
6、sofhipjointswasexcellentandgoodattheratioof93%.ConclusionTheagedpeoplewiththefemoralintertrochantericfracturesusuallyaccompaniedwithseveralinternalmedicaldisorders,andtheirgeneralconditionswerepoorandthetoleranceofoperationswasnotgood.However,thetechniquesofGammanailswassimple,withshorttim
7、e,offirmfixation,minimalinjury,lessbleedings,andwithhigh4ratioofbonyhealing.Soitwasverysuitableforthefemoralintertrochantericfractureoftheagedpeople,andworthfulforrecommendationofsurgery.［Keywords］intertrochantericfracture;elderly;internalfixation随着人口老龄化时代的到来以
