【摘要】 [目的]探讨复杂粗隆间骨折的有效治疗方法。[方法]回顾性研究35例复杂粗隆间骨折的治疗。统计骨折的分型、手术方法、手术时间、并发症、骨折愈合率。[结果]35例患者全部采用手术治疗,其中,股骨近端髓内钉(PFN)14例,动力髋螺钉(DHS)21例。手术时间1·8h(1·5~3h)。术中出血量平均300ml(150~500ml)。术后平均卧床时间2·4个月(1·2~3个月),平均随访时间12个月(6~16个月),35例中骨折愈合31例,3例延迟愈合,骨不愈合1例,愈合率88·5%。髋内翻4例(11·40%),退钉6例(8·5%),髋关节疼痛5例(14·2%)。[结论]复杂粗隆间骨折是较难处理的骨折,单独应用PFN及DHS均不能有效控制骨折的稳定性,须辅助固定大粗隆骨折块。术后辅助外固定及避免过早负重是必要的。更多还原

【Abstract】 [Objective]To discuss the effective treatment of complicate intertrochanteric hip fracture.[Method]Thirty-five cases with complicate intertrochanteric hip fracture.The class of fracture,surgery method,operating time,complicatico,union rate of fracture were amounted statisti cally.[Result]All the 35 cases were surgical treated,l 4 cases with PFN(priemeral femur nail),21 cases with DHS(dynamic hip screw)with mean time of operation 1.8 h(1.5~3 h),mean amount of blood loss during operation 300 ml(150~500 ml),mean time in bed 2.4 monthes (1.2~3 monthes),mean following-up time 12 months(6~16months).Thirty-one cases got union,3 cases union time delayed,1 case nounion,union rate was 88.5%.Four cases suffered hip iversion( 11.4%),the screw in the neck removed in 6 cases(8.5%),5 cases feeled pain in hip( 14.2% ).[Conclusion]The complicate intertrochateric hip fracture is a kind of fracture which can not be treated easily.Using PFN and DHS can not control the stability effectively.Additional fixation of the greater trochantar fracture is necessary.Added out-fixation and avoid early bearing are useful.更多还原