老年粗隆部骨折多种内固定方式的选择

目的:探讨老年人股骨粗隆部骨折的不同内固定术式选择原则。方法:对78例老年人(平均年龄76岁)股骨粗隆部骨折根据Evans分型及健康状况应用不同的内固定治疗,其中动力髋螺钉(DHS)14例、Gamma钉22例、股骨近端防旋转髓内钉(PFNA)42例。结果:78例平均随访16.5个月,按Harris评分标准,优良率84.6%。结论:根据Evans分型及健康状况选择不同的内固定手术方式均可以获得较好的手术效果,而PFNA具有最短的手术时间和最少的失血量,因此更适合高龄的患者。

Selection of Internal Fixation Methods for Femoral IntertrochantericFractures in Aged Patients

Objective: To explore the best choice of operative methods of internal fixation in aged patients with femoral inter-trochanteric fractures.Methods: 78 cases of intertrochanteric fracture patients with average ages of 76 were treated with different internal fixation methods.According to Evans classification system,14 cases were fixed with DHS,22 cases were fixed with Gamma nail,42 cas-es were fixed with PFNA.Results: All the 78 patients were followed-up for 16.5 months on average,the excellent and good rate is 84.6% in Harris score.Conclusions: Evans classification system is helpful for selecting operative method.The clinical result can be assured by choosing the right operative method.PFNA is especially suitable for elderly patients due to the shortest operation time and the least blood lost.