改良穿针外固定架与股骨近端锁定钢板治疗老年股骨转子间骨折分析

目的:分析改良穿针外固定架与股骨近端锁定钢板治疗老年人股骨转子间骨折的疗效。方法:92例70岁以上老年股骨转子间骨折患者,分为改良穿针外固定架治疗组49例,锁定钢板治疗组43例;两组一般情况比较差异无统计学意义(P>0.05)。结果:随访3～16个月,两组骨折均骨性愈合,术后按Harris标准评定两组关节功能,改良穿针外固定架组优良率为89.79%,锁定钢板组优良率为90.69%,两组优良率比较差异无统计学意义(P>0.05);术中出血量、手术时间改良穿针外固定架组明显优于锁定钢板组,两组比较差异有统计学意义(P<0.05);改良穿针外固定架组并发症2例,锁定钢板组并发症4例。结论:改良穿针外固定架较适合于年老体弱患者,改良穿针后固定可靠,能早期下地扶拐行走,手术时间短,术中出血量少,不需再次手术取内固定;股骨近端锁定钢板适合于无严重合并症的各型股骨转子间骨折患者。

Comparison of Efficacy Between Proximal Femur Plate Locking and Improved Needle External Fixator Technique in Treatment of Intertrochanteric Fracture

Objective： To compare the efficacy of improved single arm needle external fixator technique and proximal femoral locking plate in treatment of intertrochanteric fracture.Methods： 92 cases of intertrochanteric fracture patients aged more than 70 were divided into two groups,49 cases were treated by improved single arm needle external fixator technique,and 43 cases were treated by proximal femur plate locking.There was no significant difference between the two groups in general（P 0.05）.Results： 92 patients had been followed up during a period of 3 ～ 6 months and the fractures were all healed.According to Harris evaluation criteria,the excellent rates of the improved single arm needle external fixator group and the proximal femur plate locking group reached 89.79% and 90.69%,respectively,and there was no significant difference（P 0.05）.During the operation,the blood loss and average time of the improved single arm needle external fixator group were less than the proximal femur plate locking group,and there was significant difference（P 0.05）.2 cases of the infection occurred in the improved single arm needle external fixator group,and 4 cases occurred in the proximal femur plate locking group.Conclusion： The improved single arm needle external fixator technique is fit for old and weak patients,which has the properties of reliable fixation,early walking with crutches,short operation time,less blood loss and without reoperation for fixation.Meanwhile,the proximal femur plate locking is suitable for various types of non-serious complications patients with intertrochanteric fractures.