【摘要】 目的探讨老年骨质疏松性髋部骨折的手术治疗效果。方法 2000年1月~2010年12月采用手术治疗老年骨质疏松性髋部骨折117例,男53例,女64例;年龄65~95岁,平均75.7±10.3岁;股骨粗隆间骨折51例,男24例,女27例;年龄66~95岁,平均76.7±9.3岁,按Evans分型,Ⅰ型4例,Ⅱ型11例,Ⅲ型32例,Ⅳ型4例。DHS内固定36例,空心加压螺钉固定5例,人工股骨头置换6例,Gamma钉内固定4例。股骨颈骨折66例,男29例,女37例;年龄65~92岁,平均75.6±10.2岁,按分Garden分型,Ⅰ型5例,Ⅱ型13例,Ⅲ型21例,Ⅳ型27例。双极人工股骨头置换24例,人工全髋关节置换27例,空心加压螺钉固定15例。结果股骨粗隆间骨折44例获随访,随访时间8~26个月,平均15.7±3.3个月,DHS平均愈合时间为6.7±1.3个月,有3例发生股骨钉的切割。2例发生术后感染,术后10 d并发心肺功能衰竭死亡。股骨颈骨折58例随访,随访时间8~25个月,平均16.7±2.3个月;按Harris评分标准:优31例,良22例,中14例,差1例,优良率为91.38%(53/58)。结论对于骨质疏松性髋部骨折,采用手术治疗可以取得较为令人满意的疗效。更多还原

【Abstract】 Objective To explore the outcomes of operation treatment for osteoporotic hip fracture in the elder. Methods 117patients with osteoporotic hip fracture were treated with operation methods between January 2000 and December 2010, which involved 53 males and 64 females, and with mean age 75.7±10.3 years(ranged from 65 to 95 year). 51 cases were suffered from interchanteric fracture, involved 24 males and 27 females, and with mean age 76.7±9.3 years(ranged from 66 to 95 years). All fractures in the cases were divided according to Evans standard, Ⅰtype in 4 cases, Ⅱtype in11 cases, Ⅲtype 32 in cases, Ⅳ type in 4 cases. 36 cases were treated by DHS, 5 cases by hollow pull screw, 6 cases by artificial bipolar femoral head replacement and 5 cases by Gamma screw. 66 cases were suffered from femur neck fracture, which involved 29 males and 37 females, and with mean 775.6±10.2 years(ranged from 65 to 92 year). All fractures were divided according to Garden standard, Ⅰtype in 5cases, Ⅱtype in 13, Ⅲtype in 21 cases, Ⅳ type in 27 cases. 24 cases were treated by artificial bipolar femoral head replacement.27 cases were by total hip replacement. 15 cases were by hollow pull screw. Results 44 cases with interchanteric fracture were followed-up for 8~26 months with an average of 15.7±3.3 months. The average fracture healing time was 4.6 months in the DHS cases. A few of complications happen in the DHS cases, screw cutting occurred in 3 cases. 2 cases suffered from infection dead due to cardio-pulmonary failure in 10 days after operation. 58 cases with femur neck fracture were followed-up for 8~25 months with an average of 16.7±2.3 months. According to Harris scoring system, the outcomes were excellent in 30 cases, good in 22,fair in 14, and poor in 1, and the excellent good rate was 91.38%(53/58). Conclusion Operation management can achieve an excellent result in osteoporotic hip fracture in the elder.更多还原