李敬 1陈巨坤 1周凯 1沈斌 2倪向明 2陈雷1
作者信息
- 1. 温州医学院第一附属医院骨科,浙江温州,325000
- 2. 温州市第八人民医院骨科
- 折叠
摘要
Abstract
Objective:To investigate the therapeutic effect and characteristic of dynamic hip screw with modified reamer (MDHS for short) in the treatment of the intertrochanteric fracture in the elderly. Methods:Fifty-four patients with intertrochanteric fracture from Aug. 2007 to Dec. 2008 were retrospectively analyzed. Among them ,27 patients were treated with MDHS,including 12 males and 15 females with an average age of 79.4 years old ranging from 69 to 93 years;according to modified Evans classification, there were 3 cases of type Ⅰ , 12 cases of type Ⅱ , 8 cases of type Ⅲ,4 cases of type Ⅳ. The other 27 patients ( 10 males and 17 females), aged from 66 to 88 years old (average 77.2), were composed of 4 cases of type Ⅰ , 14 cases of type Ⅱ ,6 cases of type Ⅲ, 3 cases of type Ⅳ. The fracture healing time, forepart movement time, percentage of loosening screw and hip joint function were compared between two groups. Results:All 54 patients were followed up for 21 to 36 months (means 27.6 months). All fractures were bone healing. The time of fracture healing were compared between two groups, there were no significant difference (P＞0.05). The forepart movement time of M DHS group ( 14.2±2.1 ) was shorter than that of DHS group ( 18.9±3.1 ) (P＜0.05). The loosening screw of MDHS group ( 1 case) was less than that of DHS group (8 cases) (P＜0.05). The Harris score of hip joint function of MDHS group (87.8±4.7) was higher than that of DHS group (83.3±7.5)(P＜0.05). Conclusion:MDHS has several advantages on wider indications, stronger holding power,early forepart movement time, fewer complications, which is a good choice for osteoporotic intertrochanteric fracture.关键词
股骨骨折/髋骨折/骨折固定术,内/外科手术/老年人/临床对照试验Key words
Femoral fractures/ Hip fractures/ Fracture fixation, internal/ Surgical procedures, operative/ Aged/ Controlled clinical trials
