比较研究锁定加压钢板与DHS系统治疗老年股骨粗隆间骨折.docVIP

精品论文 参考文献 比较研究锁定加压钢板与DHS系统治疗老年股骨粗隆间骨折 崔泳 曹鹏 (新疆医科大学第五附属医院骨科 830011) 【中图分类号】R683【文献标识码】A【文章编号】1672-5085(2013)29-0062-03 【摘要】 目的 对比研究锁定加压钢板与DHS(动力髋螺钉)系统治疗股骨粗隆间骨折的疗效。方法　对分别应用锁定加压钢板与DHS系统治疗股骨粗隆间骨折的157例患者进行回顾性分析。其中，按照Evans分型：Ⅰ型39例，Ⅱ型18例，Ⅲ型46例，Ⅳ型54例。DHS系统治疗102例，锁定加压钢板治疗55例。结果 5例失访，其余术后随访1.4～5.2年。术后根据黄公怡髋关节功能判定标准：使用DSH系统患者优61例，良26例，差7例，优良率92.5%。使用锁定加压钢板患者优44例，良13例，差1例，优良率98.2%。结论 DHS系统与锁定加压钢板在治疗Ⅰ型Ⅱ型粗隆间骨折的疗效方面无明显差异，而锁定加压钢板在治疗Ⅲ型Ⅳ型粗隆间骨折显示出明显优势。 【关键词】股骨粗隆间骨折 骨折固定术 锁定加压钢板 DHS The comparative study of locking compression plate and dinamic hip screw in intertrochanteric fracture 【Abstract】 Objective To evaluate the treatment results of locking compression plate and DHS(Dinamic Hip Screw). Methods the retrospective analysis for intertrochanteric fracture of 157 patients, which were divided into different treatments: locking compression plate and DHS.The fractures were classified as Evans type，39 examples for type Ⅰ,18 examples for typeⅡ,46 examples for typeⅢ, 54 examples for typeⅣ . the treatments of intertrochanteric fracture were 102 examples. the treatments of DHS were 55 examples..Result Follow-up ranged from 1.4 to 5.2 years，5 examples were missed. According to the criteria of Huang Yi hip function :the results were excellent in 61 cases，good in 26cases，poor in 7 cases, excellent rate of 92.5% by using DHS. Excellent in 44 cases，good in 13 cases，poor in 1 cases, excellent rate of 98.2% by using locking compression plate. Conclusion there was no obvious result in typeⅠand Ⅱ for intertrochanteric fracture, no matter locking compression plate and DHS. But the better advantage of locking compression plate was type Ⅲ and Ⅳ for intertrochanteric fracture. 【key words】 Intertrochanteric fracture，Fracture fixation，Locking compression plate, Dinamic Hip Screw 股骨粗隆间骨折是骨科常见病与多发病，随着我国社会人口老龄化,其发生率有逐渐上升趋势。对于老年人早期手术内固定治疗可使患者尽早进行功能锻炼，减少由于长期卧床所致的各种并发症的发生，降低病死率。目前临床上最常用、最普及的内固定方法为动力髋螺钉(DHS)[1]固定，其治疗效果也得公认。但由于Ⅲ型Ⅳ型股骨粗隆间骨折较为复杂，手术中处理比较困难，往往会造成术后功能锻炼延迟，髋关节功能不佳，骨折愈合缓慢等[2]。随着骨折内固定系统的不