时　欣　严建军　赵建宏　王　萍

【摘要】 目的 回顾分析闭合复位、单臂外固定架固定治疗老年股骨转子间骨折的疗效。方法 2001年6月至2007年6月，用单臂外固定架治疗老年股骨转子间骨折56例，年龄66~94岁，平均76．3岁，所有患者至少合并一种以上系统性内科疾病。结果 56例中，4例术后6个月死于基础内科病，其余全部骨折愈合，平均愈合时间12周。最后一次随访时患者髋关节功能情况（创伤性髋关节评分系统）：优28例、良22例、差6例。结论 股骨粗隆间骨折采用闭合复位外固定架固定的方法，手术创伤小，疗效确切。特别是对于年老体弱、伴有系统性内科疾病的高危股骨转子间骨折患者是一个比较好的方法。

【关键词】外固定架；股骨粗隆间；骨折；老年

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Treatmentofintertrochanteric fracture of femur in the elderly with unilateral external fixator

SHI Xin,YAN Jian-jun,ZHAO Jian-hong,et al.Department of Orthopedics, The 2nd Affiliated Hospital of Nantong University, Nantong 226001,China

【Abstract】 Objective To retrospectively analyze the results of unilateral external fixators and closed reduction in treatment of intertrochanteric fravtures of femur in the elderly.Methods From June 2001 to June 2007, 56 high risk patients with intertrochanteric fractures were treated with closed reduction and unilateral external fixator.Their average age was 76．3 years (ranging from 66 to 94 years).Allthe patients were comlicated with at least one systematic disease.Results 4 cases died of basic internal disease 6 months after operation, All the rest healed after 12 weeks on average.The latest follow-up showed that the functional outcomes were excellent in 28 cases, good in 22 and poor in 6 according to traumatic hip rating score.Conclusion Close reduction and external fixation is better in treatment of intertrochanteric fracture of femur, because it in fewer traumas or complications, and better functional recovery for high-risk geriatric patients.

【Key words】External fixation;Intertrochanteric;Fracture；Elderly

股骨粗隆间骨折是老年人的常见病, 常为步行摔倒等低能量损伤所致。随着社会人口老龄化，其发生率明显上升。老年患者往往合并多种内科疾病，不能耐受较大的手术，切开复位内固定往往成为禁忌，外固定架固定具有创伤小、失血少、方法简单、安全、经济的优点，可能是这类患者的首要选择。2001年6月至2007年6月本科采用单臂外固定架(在C型臂X线机监视下)治疗老年股骨粗隆间骨折56例，治疗效果满意。现报告如下。

1 临床资料

1．1 一般资料 本组56例，男25例，女31例；年龄66~94岁,平均76．3岁。致伤原因：摔伤47例，交通伤9例。按照Evans^[1]分型：Ⅱ型5例，ⅢA型26例，ⅢB型14例，Ⅳ型8例，逆粗隆间骨折3例。合并有高血压29例，慢性支气管炎17例，冠心病21例，心律失常12例，2型糖尿病17例，脑梗死后遗症15例, 贫血：轻度21例，中度7例。……