Guo Long, Fan Shun-wu
Zhongguo Gu Shang. 2015 Nov;28(11):1048-52.
To evaluate the clinical effects of minimal invasion and closed reduction with external fixation in treating elderly femoral intertrochanteric fracture.
From August 2007 and September 2013, 43 patients with elderly femoral intertrochanteric fracture were treated by minimal invasion and closed reduction with external fixation. There were 26 males and 17 females with an average age of 78 years old ranging from 68 to 92 years. Durations from injury to operation ranged from 1 to 8 days with an average of 3 days. According to AO classification, there were 22 cases with type A1, 15 with type A2, 6 with type A3. The time of bone healing were observed after operation and the clinical effects were evaluated by Harris scoring standard.
All patients were followed up from 10 to 18 months with an average of 13 months. The incisions obtained one-stage healing after removal of external fixation. All the fractures were healed and the mean healing time was 16 weeks (ranged, 12 to 18 weeks). Two patiens complicated with the thread needle loosening in the femoral trochanteric, 2 cases with the hip varus deformity and 1 case with the delayed union. No bone nonunion, external fixer breakage, blood vessel or nerve damage were found. According to the Harris scoring standard,the average Harris score of hip joint function was 85.89±7.36, and 18 cases got excellent results, 19 good.
Minimal invasion and closed reduction with external fixation can obtain satisfactory results in treating elderly femoral intertrochanteric fractures. It is a simple and effective method for elderly patients who cannot tolerate anesthesia and surgery trauma.
评估微创闭合复位外固定治疗老年股骨转子间骨折的临床疗效。
2007年8月至2013年9月,对43例老年股骨转子间骨折患者采用微创闭合复位外固定治疗。其中男性26例,女性17例,平均年龄78岁,年龄范围68~92岁。受伤至手术时间为1~8天,平均3天。按AO分型,A1型22例,A2型15例,A3型6例。术后观察骨折愈合时间,采用Harris评分标准评估临床疗效。
所有患者随访10~18个月,平均13个月。拆除外固定后切口一期愈合。所有骨折均愈合,平均愈合时间为16周(12~18周)。2例患者出现股骨转子部螺纹针松动,2例出现髋内翻畸形,1例出现骨折延迟愈合。未发现骨不连、外固定架断裂及血管神经损伤。按Harris评分标准,髋关节功能平均Harris评分为85.89±7.36,优18例,良19例。
微创闭合复位外固定治疗老年股骨转子间骨折可取得满意疗效。对于不能耐受麻醉和手术创伤的老年患者,是一种简单有效的方法。