闭合复位DHS治疗老年股骨转子间骨折45例体会

目的探讨闭合复位DHS内固定治疗老年股骨转子间骨折的方法与疗效。方法2002年9月至2007-10月采用闭合复位DHS内固定治疗老年股子间转子骨折45例，所有病例均为单发，入院后行患肢持续牵引复位，内科疾病经治疗稳定后再行手术，所有病例术中行下肢骨折整复外固定后小切口置入DHS内固定系统，术后功能锻炼，骨折愈合后逐步负重行走。结果随访43例，随访时间8个月-5年，平均22个月，骨折平均愈合时间为3个月，均全部骨性愈合。髋关节功能评分优良率为88．4％，术后髋外翻2例，髋内翻1例，息肢外旋畸形1例，患肢深静脉栓塞2例，切口感染1例。结论闭合复位DHS小切口内固定术在严格掌握适应症的情况下能取得良好的临床效果，符合生物接骨术的原则与要求，是一种较简便行之有效的治疗老年股骨转子间骨折的方法。

Experience of 45 cases of elder trochanteric femur fractures with treatment of closed reset method DHS

Objective：To explore the method and effect of dosed reset method DHS in treatment of trocanteric femur fractures. Method： To take 45 elderly cases as examples. All cases are singly affected.. After admission into hospital,the affected limb has been continually reset and accepted operation after physical treatment. All the cases take lower-limb restoration and external fixation,with DHS internal fixation system transformed in by a small incision.And all of them can have weight -beating walk after recovery of fracture. Result： The follow-up of 43 cases lasted from 8 months to 5 years,Which is 22 months in average.The time for average fracture recovery is 3 months.All of them are entirely recovered judging from the hip function estimation rules by Dong Jiyuan,the excellence rate is 88.4%.Among all the cases,2 of them have hip eversion,1 varus,1 external rotation deformity,2 deep vein thrombosis and 1 incision infection. Conclusion： Closed reset method DHS fixation with small incision can achieve very good clinic result under circumstance of strict indications.It keeps well with the rules and requirements of biological osteesynthesis and is a simple and effective way to treat femoral fractures in elderly.