摘要
目的探讨股骨近端锁定钢板（LPFP）内固定治疗老年股骨粗隆间骨折的临床疗效。方法回顾性分析自2008-01—2013-12诊治的29例股骨粗隆间骨折,均采用切开复位LPFP内固定治疗。若股骨小粗隆破坏严重并伴有骨缺损,采用自体髂骨植骨。结果本组手术时间60～105 min,平均68 min;术中出血量180～760 ml,平均295 ml。其中有12例术中或术后输血。所有患者切口均一期愈合,无切口延迟愈合或感染。29例术后均获得平均12.1（6～18）个月随访。骨折愈合时间4～15个月,平均5.9个月。末次随访时根据髋关节功能Harris评分标准评定疗效：优15例,良11例,可2例,差1例,优良率89.7%。术后1例下肢肿胀,经B超证实为下肢DVT,经内科2周积极抗凝溶栓等治疗,预后良好。1例发生褥疮。无螺钉松动、断钉、髋内翻及肢体短缩等并发症发生。本组并发症发生率为6.9%。结论 LPFP内固定治疗老年股骨粗隆间骨折具有手术操作简便、固定可靠、并发症少等优点,是一种理想的手术治疗方法。
Objective To investigate locking proximal femoral plate（LPFP） for treatment of senile femoral intertrochanteric fractures. Methods From January 2008 to December 2013,29 patients with femoral intertrochanteric fracture were retrospectively analyzed,who received open reduction and LPFP internal fixation. If the lesser trochanter of the femur was severely damaged with bone defects,autologous bone grafts were used. Results The average operative time of patients in this group was 68 minutes,blood loss averaged 295 ml. Twelve cases received intraoperative or postoperative blood transfusion. All wounds were healed,there were no delayed wound healing or infection. Twenty nine patients were followed up for an average of 12.1 months（6 to 18 months） after operation. The fracture healing time of this group was 4 to 15 months,with an average 5.9months. At last follow-up,the efficacy was evaluated based on the standard of Harris hip score： excellent in 15 cases,good in11 cases,acceptable in 2 cases,bad in 1 case,the excellent and good rate was 89.7%. One case had deep vein thrombosis after operation,Two weeks after medical positive anticoagulant and thrombolytic therapy,the prognosis was good. One case had bedsores. There were no loose screws,no broken nails,no pressure ulcers,no limb shortening varus and other complications.The complication rate was 6.9%. Conclusion With the advantages of simple operation,reliable and secure fixation,less morbidity,etc.,locking proximal femoral plate is an ideal method for treatment of senile femoral intertrochanteric fractures.
出处
《中国骨与关节损伤杂志》
2015年第6期586-588,共3页
Chinese Journal of Bone and Joint Injury
关键词
股骨粗隆间骨折
股骨近端锁定钢板
内固定
老年
Femoral intertrochanterie fractures
Locking proximal femoral plate
Internal fixation
Elderly
