不同方法治疗老年型骨质疏松症患者转子间骨折疗效分析

叶斌; 陈友燕; 马辉; 孙伟; 周扬; 陆洋阳; 谢伟; 张驰

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不同方法治疗老年型骨质疏松症患者转子间骨折疗效分析

叶斌 , 陈友燕 , 马辉 , 孙伟 , 周扬 , 陆洋阳 , 谢伟 , 张驰

文章导航 > 蚌埠医学院学报 > 2010, 35 > 11: (1096-1098)

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不同方法治疗老年型骨质疏松症患者转子间骨折疗效分析

1. 上海市杨浦区老年医院骨科, 200090;
2. 第二军医大学附属长海医院骨科, 上海 200433

作者简介: 叶斌(1967-),男,副主任医师,副教授.

中图分类号: R681

Clinical effective analysis of geriatric osteoportic patient with intertrochanteric hip fracture

1. Department of Orthopaedics, Yangpu Geriatric Hospital, Shanghai 200090;
2. Department of Orthopaedics, Changhai Hospital of The Second Military Medical University, Shanghai 200433, China
CLC number: R681

摘要: 目的:探讨老年型骨质疏松症患者转子间骨折的不同治疗方法的临床疗效。方法:回顾分析268例老年型骨质疏松症患者转子间骨折治疗临床资料;其中保守治疗68例,多枚空心钉内固定36例,Richard钉与抗旋转螺釘内固定136例,股骨近端髓内钉内固定28例。结果:手术治疗197例骨折愈合,平均愈合时间2.6个月,病死3例;保守治疗62例骨折愈合,平均愈合时间4.2个月,病死22例;手术治疗效果明显优于保守治疗(P<0.01)。股骨近端髓内钉和Richard钉固定的患者未出现髋内翻,无内固定物折弯、皮质骨钉断裂等内固定物意外;多枚空心钉固定的患者中17例出现轻度髋内翻。结论:老年型骨质疏松症患者转子间骨折应根据身体情况尽快选择适合的治疗方法,治疗宜优先考虑内固定手术;内固定的选择应按减少并发症、减少转子区骨量丢失、支撑牢固、骨折愈合快、功能恢复理想的顺序。
- 骨质疏松 /
- 转子间骨折 /
- 保守治疗 /
- 手术治疗
Abstract: Objective:To compare the clinical effect of elderly patients with osteoporotic intertrochanteric fracture with the different treatment.Methods:Two hundred and sixty-eight old patients with osteoporotic intertrochanteric fracture were investigated retrospectively.All patients were divided into expectant treatment group (68 cases),the hollow nail group (36 cases),Richard nail group (136 cases),and proximal femoral nail (PFN) (28 cases).Results:There were 200 patients that underwent the surgical treatment.One hundred and ninty-seven patients received fracture healing and 3 patients died.The average healing time was 2.6 months.Meanwhile,in the conservative treatment group 62 patients received fracture healing and 22 patients died.The average healing time was 4.2 months.The effect of the surgical treatment is better than the conservative treatment (P<0.01).There were no coxa vara,the internal fixation bending,cortical bone screw implant rupture in the PFN and Richard screw fixation treatment group.The coxa vara occurred in 17 patients with cannulated screws fixation.Conclusions:Elderly patients with osteoporotic intertrochanteric fractures should be treated on the basis of the body condition as soon as possible.The internal fixation treatment should be given priority.The ideal internal fixation should be to reduce complications,reduce bone loss in the intertrochanteric area,strongly sustaining,fracture healing,functional recovery.
- osteoporotic /
- intertrochanteric fracture /
- expectant treatment /
- surgery

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不同方法治疗老年型骨质疏松症患者转子间骨折疗效分析

作者简介: 叶斌(1967-),男,副主任医师,副教授.

1. 上海市杨浦区老年医院骨科, 200090;
2. 第二军医大学附属长海医院骨科, 上海 200433

收稿日期: 2009-12-28

关键词:

摘要: 目的:探讨老年型骨质疏松症患者转子间骨折的不同治疗方法的临床疗效。方法:回顾分析268例老年型骨质疏松症患者转子间骨折治疗临床资料;其中保守治疗68例,多枚空心钉内固定36例,Richard钉与抗旋转螺釘内固定136例,股骨近端髓内钉内固定28例。结果:手术治疗197例骨折愈合,平均愈合时间2.6个月,病死3例;保守治疗62例骨折愈合,平均愈合时间4.2个月,病死22例;手术治疗效果明显优于保守治疗(P<0.01)。股骨近端髓内钉和Richard钉固定的患者未出现髋内翻,无内固定物折弯、皮质骨钉断裂等内固定物意外;多枚空心钉固定的患者中17例出现轻度髋内翻。结论:老年型骨质疏松症患者转子间骨折应根据身体情况尽快选择适合的治疗方法,治疗宜优先考虑内固定手术;内固定的选择应按减少并发症、减少转子区骨量丢失、支撑牢固、骨折愈合快、功能恢复理想的顺序。

English Abstract

Clinical effective analysis of geriatric osteoportic patient with intertrochanteric hip fracture

1. Department of Orthopaedics, Yangpu Geriatric Hospital, Shanghai 200090;
2. Department of Orthopaedics, Changhai Hospital of The Second Military Medical University, Shanghai 200433, China

Received Date: 2009-12-28

Abstract: Objective:To compare the clinical effect of elderly patients with osteoporotic intertrochanteric fracture with the different treatment.Methods:Two hundred and sixty-eight old patients with osteoporotic intertrochanteric fracture were investigated retrospectively.All patients were divided into expectant treatment group (68 cases),the hollow nail group (36 cases),Richard nail group (136 cases),and proximal femoral nail (PFN) (28 cases).Results:There were 200 patients that underwent the surgical treatment.One hundred and ninty-seven patients received fracture healing and 3 patients died.The average healing time was 2.6 months.Meanwhile,in the conservative treatment group 62 patients received fracture healing and 22 patients died.The average healing time was 4.2 months.The effect of the surgical treatment is better than the conservative treatment (P<0.01).There were no coxa vara,the internal fixation bending,cortical bone screw implant rupture in the PFN and Richard screw fixation treatment group.The coxa vara occurred in 17 patients with cannulated screws fixation.Conclusions:Elderly patients with osteoporotic intertrochanteric fractures should be treated on the basis of the body condition as soon as possible.The internal fixation treatment should be given priority.The ideal internal fixation should be to reduce complications,reduce bone loss in the intertrochanteric area,strongly sustaining,fracture healing,functional recovery.