微创经皮动力髋螺钉内固定配合中药治疗老年股骨转子间骨折42例

目的观察微创经皮动力髋螺钉(DHS)内固定配合中药治疗老年股骨转子间骨折的临床疗效。方法将84例符合老年股骨转子间骨折的患者随机配对分为治疗组、对照组各42例,对照组在处理原发病的基础上采用微创DHS内固定治疗,治疗组在对照组的基础上按骨折三期辨证内服中药治疗。随访15个月比较两组综合疗效及并发症情况。结果治疗组优良率为95.2%,对照组优良率为80.9%,两组比较具有显著差异(P<0.05)。两组并发症情况比较显示治疗组出现骨延迟愈合1例,髋内(外)翻畸形7例,股骨颈短缩5例;对照组出现内固定失败1例,下肢深静脉血栓2例,骨延迟愈合3例,髋内(外)翻畸形16例,股骨颈短缩8例。治疗组并发症少于对照组,其中髋内(外)翻畸形方面有显著差异(P<0.05)。结论微创DHS内固定配合中药治疗老年股骨转子间骨折不仅可明显提高综合疗效,亦能明显降低并发症的发生率,且符合基层医院的医疗水平实际,值得临床进一步深入研究。

Internal fixations of minimally invasive percutanous dynamic hip screws (DHS) combined with Chinese medicinal herbs for femoral intertrochanteric fracture in the elderly.

Objective To investigate the results of internal fixations of minimally invasive percutanous dynamic hip screws (DHS) combined with Chinese medicinal herbs for the treatment of femoral intertrochanteric fracture in the elderly.Methods 84 old patients with femoral intertrochanteric fracture were randomly assigned to study group (n=42) or control group (n=42). Control group patients were treated with minimally invasive DHS internal fixations, study group patients were treated with minimally invasive DHS internal fixations and Chinese medicinal herbs based on syndrome differentiation. After a follow-up of 15 months, results were compared between the two groups.Rusults Good results were obtained in 95.2% of the patients in study group and 80.9% of the patients in control oup, the difference was significantly different (P<0.05). Study group patients had following complications: delayed bony union (n=1), coax valga or coax vara (n=7), short femoral neck (n=5); Control group had following complications: fixation failure (n=1), deep vein thrombosis of the leg (n=2), delayed bony union (n=3), coax valga or coax vara (n=16) and short femoral neck (n=8). Complications were significantly less in study group, especially coax valga or coax vara (P<0.05).Conclusion Minimally invasive DHS internal fixations combined with Chinese medicinal herbs for the treatment of femoral intertrochanteric fracture in the elderly can increase therapeutic efficacy with few complications, deserves further study.