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| 老年骨质疏松患者股骨粗隆间骨折治疗的研究 |
| Experience of the treatment of intertrochanteric fractures in elder osteoporosis patients |
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| DOI： |
| 中文关键词: 老年人 骨质疏松 股骨粗隆间骨折 |
| 英文关键词:Senior citizen 0steoporosis Femoral intertroehanterie fracture |
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| 中文摘要: |
| 目的 比较不同方法治疗老年骨质疏松患者股骨粗隆间骨折的结果.方法 从1990年至2006年我院收治老年骨质疏松股骨粗隆间骨折患者49例,分别采用保守治疗、外固定架及多种内固定器材手术治疗并比较疗效.结果 术后平均随访3年,并发症最少的是采用重建交锁髓内钉内固定治疗.结论 股骨重建交锁髓内钉是目前治疗股骨粗隆间骨折的一种较好的方法.在实际操作中常发生导针或防旋钉将主钉向上推移的现象,导致拉力钉在股骨颈中位置偏上,应在定位钻孔时施加外力固定.防止主钉上移.伴有骨质疏松老年转子部骨折,普遍伴有大转子粉碎骨折,术中一定要在透视下探入主钉导针,避免形成假道,加重股骨近端及大转子的破坏程度不利于骨折愈合.另外,应注意因严重骨质疏松患者内固定螺钉在股骨头内深度不够不能有效固定的问题,拉力螺钉应在股骨颈中下1/3处深及股骨头下0.5～1.0 cm位置,拧入到钉尾靠近骨皮质时要注意,防止原地空转破坏骨孔道螺纹,降低拉力螺钉的固定力. |
| 英文摘要: |
| Abstract：Objeefive To compare the outcomes of varied treatment methods for intertrochanteric fractures in elder osteoporosis patient．Methods Forty-nine elder osteoporosis patients with intertrochanteric fractures were admitted in our hospital from 1990 to 2006．The fracture healing was evaluated and the complications were compared among conservative treatment alone，external bracket fixing，and surgery using many kinds of internal fixation equipments，after εa 3-year follow up of the patients．Results All the fractures were healed well in these patients．The least complication occurred in the internal fixation treatment using the intracavity cross-lock nail．Conclusion Internal fixation using the intracavity cross-lock nail is a better method for intertrochanterie osteoporotic fractures．One should guarantee the fixation force of the proximal fixation nail，and prevent the trochanteric bone from further damage． |
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