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1、中华现代外科学杂志JournalofChineseModernSurgery2006年第3卷第16期·1297··论著·高龄患者股骨粗隆间骨折手术治疗体会李凡,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8613%。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
2、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[中图分类号]R683[文献标识码]A[文章编号]1681-102X(2006)16-1297-03Surgicale
3、xperiencesofthefemoralintertrochantericfracturesoftheagedpeopleLIFan,HUANGJian2hua,TAOJie,etal.DepartmentofOrthopaedics,ShanghaiFirstPeople곰sHospital,Shanghai200080,China[Abstract]ObjectiveTodiscussthesurgicalmethodandefficacyofthefemoralintertrochantericfracturesoftheagedpeople.Meth
4、odsFromJan,2003toFeb,2006,44patients(morethan75yrs)withthefemoralintertro2chantericfracturesweresurgicallytreated.Amongthem,therewere15maleand29femalepatients,andtheagerangevariedfrom75to93yrs(theaverageagewas82yrs,also4patientswasmorethan90yrs).38patients(a2bout8613%)ofallaccompanie
5、dbyotherinternalmedicaldisorders,andthetreatmentofall44patientswerese2lectedwithGammanails.ResultsAfterperi2operativepreparations,44patientsweresuccessfullyoperated.Butonepatientsdiedafteroperation,andother43patientswerefollowedupfor5to18monthspost2operations(meantimewas11months).The
6、fracturesof43patientswithfemoralintertrochantericfractureswerehealedbetween3to6monthsafteroperations.Meanwhile,therewerenocomplicationsoccurred:suchashipvarus,shorteningoflowerextramity,infections,breakofGammanails,orwithdrawofnails.Thefunctionsofhipjointswasexcellentandgoodattherati
7、oof93%.ConclusionTheagedpeoplewiththefemoralintertrochantericfracturesusuallyaccompaniedwithseveralinternalmedicaldisorders,andtheirgeneralconditionswerepoorandthetoleranceofoperationswasnotgood.However,thetechniquesofGammanailswassimple,withshorttime,offirmfixation,minimalinjury,les
8、sbleedings,a
