老年人股骨转子间骨折动力髋螺钉的手术治疗

目的 探讨老年人股骨转子间骨折的动力髋螺钉(dvnatalc hip screw，DHs)内固定手术治疗方法及临床效果评价。方法 对1996年1月～2003年4月通过DHs手术治疗、得到随访的老年人股骨转子间骨折117例作病例回顾性分析。探讨老年人股骨转子间骨折的特点及DHs内固定手术的技巧。结果 术后随访时间为6～35个月，平均15．1个月。住院期间无死亡病例?疗效评定为优28例，良66例，可23例。优良率80N，。共有10例发生了术后并发症，其中髋内翻4例，伤口浅表感染2例，肺部感染1例，泌尿系感染2例，深部静脉血栓l例。结论 老年人股骨转子间骨折多发生于低能量损伤，多合并内科疾病，DHS可以对其进行有效的固定，并且具有操作方便，手术时间短，出血少的优点。手术前后进行骨质疏松及伴发的内科疾病的治疗和控制十分重要。

Assessment of the curative effects of DHS (dynamic hip screw) in treating senile intertrochanteric fractures

Objective To evaluate the curative effects of DHS(dynamic hip screw) in treating senile intertrochanteric fractures and discuss the clinical manifestations of the fractures. Methods The retrospective study covered 117 patients (69 female, 48male) over 60 years old who had undergone operations with DHS reduction and internal fixation from January 1996 to April 2003. The characteristics of clinical manifestations and curative effects of the senile intertrochanteric fractures were evaluated. And also the operation techniques were assessed. Results All the patients were followed up for a mean time of 15.1 months(from 6 to 35 months). No patient died during hospitalization. 10 cases had postoperative complications: 4 coax vara, 2 superficial incision infection, 1 lung infection, 2 urinary infection and 1 deep venous thrombosis. The result was excellent in 28 cases, good in 66 cases, and fair in 23 cases. The excellent and good rate was 80%. Conclusions The senile intertrochanteric fractures are often caused by low energy injuries and different from those of the young. Most of the senile patients suffer internal diseases and osteoporosis which increase the difficulties of internal fixation. But DHS internal fixation is an ideal method because of its easy technique, less operation time and less trauma. The treatment of the accompanied internal diseases and osteoporosis before and after operation is very important.