姚保平　李敏　刘红贤　王雅文　贾澜

【摘要】 目的 探讨应用空心加压螺纹钉结合股骨近端解剖型锁定钢板治疗老年股骨转子间骨折的疗效。方法 对19例老年股骨转子间骨折行空心加压螺纹钉结合股骨近端解剖型锁定钢板治疗患者进行术中观察及术后随访。结果 手术时间40～95 min， 术中失血量203～256 ml， 所有患者切口均Ⅰ期愈合， 下肢静脉血栓2例， 经保守治疗痊愈。19例均获得随访， 时间6～18个月， 骨折愈合时间16～24周。19例患者骨折均愈合， 均无钢板、螺钉松动、断裂及退钉现象， 无明显患髋部不适表现， 髋关节活动良好， 无伤口感染。所有患者均在术后6个月按照Sander标准评分：优16例， 良2例， 差1例， 优良率94.7%。结论 空心加压螺纹钉结合股骨近端解剖型锁定钢板治疗老年股骨转子间骨折的设计合理， 术中操作简单， 术后固定牢靠， 并且利于骨折的愈合， 能有效减少并发症的发生， 值得基层医院推广应用。

【关键词】 股骨转子间骨折；老年；空心加压螺纹钉；解剖型锁定钢板

DOI：10.14163/j.cnki.11-5547/r.2016.05.007

Hollow compressive screw combined with proximal femoral anatomic locking plate in the treatment of senile intertrochanteric fracture YAO Bao-ping， LI Min， LIU Hong-xian， et al. Gansu Chengxian County Peoples Hospital， Longnan 742500， China

【Abstract】 Objective To investigate curative effect by hollow compressive screw combined with proximal femoral anatomic locking plate in the treatment of senile intertrochanteric fracture. Methods Intraoperative observation and postoperative follow-up were taken in 19 senile intertrochanteric fracture patients who received hollow compressive screw combined with proximal femoral anatomic locking plate. Results Operation time was 40～95 min， and intraoperative bleeding volume as 203～256 ml. All cases had stage Ⅰhealing， and there were 2 cases cured by conservative treatment for lower limb vein thrombosis. All the 19 cases received follow-up for 6～18 months， which showed their fracture healing time as 16～24 weeks. All the 19 cases healed without loosen and fractured screw or plate， discomfort in hip， or incision infection， and with good hip joint activity. Sander standard score in 6 months after operation showed 16 excellent cases， 2 good cases， and 1 poor case， with the good rate as 94.7%. Conclusion Combination of hollow compressive screw and proximal femoral anatomic locking plate in treating senile intertrochanteric fracture is rational， easy operating with firm fixation after operation. This method is helpful for fracture healing and reducing incidence of complications. It is worth promoting and applying in primary hospital.

【Key words】 Intertrochanteric fracture； Senile； Hollow compressive screw； Anatomic locking plate

股骨转子间骨折好发于中老年骨质疏松患者， 占全身骨折的1.4%[1， 2]， 占成人骨折的3.1%。随着我国步入老龄化社会， 股骨转子间骨折的发生率逐年增高， 其发病数量也逐渐增加， 手术治疗已成为国内外公认的首选治疗方法[3]。股骨转子间骨折的手术固定方法较多， 但尚无一种内固定完全满意针对多种类型的股骨转子间骨折[4]。自2012年2月～ 2014年8月， 作者采用空心加压螺纹钉结合股骨近端解剖型锁定钢板手术治疗老年股骨转子间骨折患者19例， 均取得良好疗效， 现报告如下。……