【摘要】 目的对微创动力髋螺钉(MIDHS)与传统动力髋螺钉(CDHS)固定老年股骨转子间骨折的疗效进行比较。方法2006年4月~2009年2月,本院应用微创技术与传统技术行DHS固定股骨转子间骨折并获得9个月以上随访119例,其中M IDHS组51例,CDHS组68例,手术方式为C臂X光机引导下行骨折闭合复位、微创DHS固定或传统技术行切开复位DHS固定。所有Evans不稳定型骨折均同时于DHS头钉近侧放置1枚防旋松质骨螺钉。结果119例获得平均22.4个月(9~40个月)的随访,两组患者在骨折功能复位率、内固定位置满意率、严重并发症率、骨折愈合时间及愈合率等各方面的差异没有统计学意义;而在手术切口长度、手术时间、失血量、术后住院时间及髋关节Harris评分等方面的差异有统计学意义。结论若股骨转子间骨折复位及内固定位置满意,微创或传统技术行DHS固定均是安全而有效的治疗方式,而微创DHS固定股骨转子间骨折是较好的选择。更多还原

【Abstract】 Objective To compare the treament effect of intertrochanteric fractures in the elderly by minimally invasive dynamic hip screws(MIDHS) and conventional dynamic hip screws(CDHS). Methods From April 2006 to February 2009,119 consecutive aged patients with intertrochanteric fracture treated with dynamic hip screws(DHS) were followed up more than 9 months.They were divided into two groups according to surgical technique.The MIDHS group includes 51 patients with an average age of 67.5 years,and the CDHS group includes 68 patients with an average age of 66.4 years.Both groups are similar in ordinary condition,injury mechanism,fracture types,singh index,garden reduction index and medical disease.All cases were treated by closed reduction and minimally invasive technique under fluoroscopy guidance in the MIDHS group,or treated by open reduction and internal fixation in the CDHS group.An additional,anti-rotational and large cancellous bone screw cranial and parallel to the lag screw was used in each unstable fracture. Results 119 patients were followed up for 22.4(9~40) months on the average.The adequate reduction,adequate internal fixation position,serious complication,union time and union rate is not significantly different between the two groups.The CDHS group have significantly larger wound incision,longer surgery time,more blood loss,longer postoperative hospital stay and lower Harris hip scores when compared with the MIDHS group. Conclusion Either a MIDHS or a CDHS in the treatment of intertrochanteric fractures is a safe and effective method.The minimally invasive technique is prior to the conventional technique.更多还原